Transesophageal Echocardiography (TEE)

Transesophageal echocardiography (TEE) is covered when transthoracic echocardiography (TTE) is technically inadequate or when TEE will provide additional information that significantly impacts management (e.g., endocarditis with non-diagnostic TTE, suspected prosthetic valve dysfunction, intracardiac thrombus evaluation, aortic pathology, complex congenital or interventional guidance, and certain critically ill patients). Routine screening, serial pericardial assessment when TTE is adequate, intraoperative monitoring-only TEE, and unsupported use of 3D echocardiography alone are not covered. Documentation of clinical necessity, a complete physician interpretation, and appropriate technician and physician credentials are required for coverage.

"TEE is covered when transthoracic echocardiography (TTE) is technically inadequate or does not provide sufficient data for definitive therapeutic decision-making."