Summary & Overview
HCPCS Level II C8925: Transesophageal Echocardiography (TEE) With Contrast
HCPCS Level II code C8925 represents transesophageal echocardiography (TEE) performed with contrast — or initially without contrast followed by with contrast — with real-time 2D image documentation, including probe placement, image acquisition, interpretation and report. TEE with contrast is a specialized diagnostic cardiac imaging procedure used to evaluate cardiac structure and function when transthoracic imaging is inadequate or when enhanced delineation of intracardiac structures is required. Nationally, accurate coding of TEE with contrast affects clinical documentation, utilization tracking, and payment for high-acuity cardiac imaging.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare and Medicare. The publication outlines coverage and billing benchmarks relevant to hospital and ambulatory settings and summarizes typical payer considerations for procedural documentation and imaging reports.
Readers will find a concise clinical and coding overview, guidance on common billing contexts for imaging departments, and a summary of what to expect for reimbursement pathways and utilization monitoring. The content highlights where the code is used, the clinical scenarios prompting contrast-enhanced TEE, and the operational sites of service. Data not available in the input is clearly identified where applicable.
Billing Code Overview
HCPCS Level II code C8925 describes transesophageal echocardiography (TEE) with contrast, or without contrast followed by with contrast, real time with image documentation (2D) (with or without M-mode recording). The service includes probe placement, image acquisition, interpretation and report.
Service Type: Diagnostic cardiac imaging — transesophageal echocardiography with contrast
Typical Site of Service: Hospital inpatient or outpatient imaging suite, ambulatory surgical center, or cardiac catheterization laboratory where transesophageal echocardiography procedures are performed
Clinical & Coding Specifications
Clinical Context
A 68-year-old male with a history of atrial fibrillation, prior cryptogenic stroke, and known left atrial appendage thrombus is admitted for evaluation of embolic source and perioperative cardiac assessment. The cardiology team orders a transesophageal echocardiogram to visualize cardiac structures not well seen on transthoracic study.
The clinical workflow: the patient is consented and fasting. Sedation and topical anesthesia are provided by anesthesia or the cardiology team. A transesophageal echocardiography (TEE) probe is placed by an echocardiographer or cardiologist. Real-time 2D images are acquired with and without echocardiographic contrast per clinical indication; if initial images are suboptimal, contrast is administered and additional imaging is captured. The study includes probe placement, multiplane image acquisition, optional m-mode recording, interpretation by the performing physician, and a formal report documented in the medical record. The procedure may occur in an echocardiography lab, cardiac catheterization lab, operating room, or intensive care unit depending on patient stability and indication.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing physician interpretation separate from technical component |