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A fetal biophysical profile (BPP) is a diagnostic procedure that utilizes ultrasound imaging to assess various aspects of fetal well-being during pregnancy. The BPP evaluates critical parameters such as the volume of amniotic fluid, fetal breathing movements, gross body movements, and fetal muscle tone. This assessment is crucial for predicting potential fetal distress, specifically the presence or absence of fetal asphyxia, and for determining the risk of fetal death during the antenatal period. The procedure is typically performed when the mother presents with a full bladder, which enhances the clarity of the ultrasound images. During the BPP, an acoustic coupling gel is applied to the skin of the lower abdomen to facilitate the transmission of ultrasound waves. A transducer is then placed against the skin and moved across the lower abdomen to locate the fetus and assess cardiac activity. The examination may also include observations of placental position. Following the initial assessment, the ultrasound is used to measure amniotic fluid volume, evaluate fetal movements, and assess breathing patterns. Although the BPP can be performed without a non-stress test (NST), it may also include NST, which involves continuous fetal heart rate monitoring for a minimum of 30 minutes. The results of the BPP are quantified into a biophysical score (BPS), which helps healthcare providers determine the risk of fetal complications. The physician is responsible for reviewing the ultrasound images, interpreting the NST results, calculating the BPS, and providing a comprehensive written report of the findings.
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The fetal biophysical profile (BPP) is indicated for the following conditions:
The procedure for conducting a fetal biophysical profile (BPP) involves several key steps:
After the fetal biophysical profile (BPP) is completed, the physician will review the results and discuss them with the patient. If the BPS indicates a normal fetal condition, routine prenatal care may continue. However, if the BPS suggests potential fetal distress or other complications, further monitoring or interventions may be recommended. The patient may be advised on follow-up appointments or additional testing based on the findings. It is essential for the healthcare provider to communicate any concerns and outline the next steps in the management of the pregnancy.
| Short Descr | FETAL BIOPHYS PROFIL W/O NST | Medium Descr | FETAL BIOPHYSICAL PROFILE W/O NON-STRESS TESTING | Long Descr | Fetal biophysical profile; without non-stress testing | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 1 - Diagnostic Tests for Radiology Services | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Procedure or Service, Not Discounted when Multiple | ASC Payment Indicator | Radiology service paid separately when provided integral to a surgical procedure on ASC list; payment based on MPFS nonfacility PE RVUs. | Type of Service (TOS) | 4 - Diagnostic Radiology | Berenson-Eggers TOS (BETOS) | I3B - Echography/ultrasonography - abdomen/pelvis | MUE | 2 | CCS Clinical Classification | 197 - Other diagnostic ultrasound |
| 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | TC | Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles | GC | This service has been performed in part by a resident under the direction of a teaching physician | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | CR | Catastrophe/disaster related | GA | Waiver of liability statement issued as required by payer policy, individual case | KX | Requirements specified in the medical policy have been met | PD | Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | SA | Nurse practitioner rendering service in collaboration with a physician | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2002-01-01 | Changed | Code description changed. |
| 2001-01-01 | Added | First appearance in code book in 2001. |
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