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The CPT® Code 76820 refers to the procedure known as Doppler velocimetry, specifically focusing on the umbilical artery. This diagnostic test is performed by a physician to assess the blood flow velocity within the umbilical artery of a fetus. The primary purpose of this procedure is to aid in determining the optimal timing for labor induction and to diagnose or evaluate conditions such as fetal anemia. During the procedure, the mother is typically positioned in a semi-recumbent posture with a slight lateral tilt. This positioning is crucial as it helps to reduce the risk of supine hypotension syndrome, a condition that can occur when a pregnant woman lies flat on her back. To initiate the test, an acoustic coupling gel is applied to the skin of the lower abdomen, which enhances the transmission of sound waves. A transducer is then placed against the lower abdomen, and the physician manipulates it to capture Doppler frequency shift waveforms from the umbilical artery. The assessment of umbilical artery blood flow is conducted using either continuous wave or pulsed wave Doppler interrogation techniques, which evaluate the downstream impedance of the blood flow. The resulting Doppler waveforms are displayed on a video monitor, allowing for real-time visualization of the blood flow dynamics. When appropriate signals are identified, the screen is frozen to facilitate accurate measurements. These measurements are critical as they are used to calculate various indices that characterize the downstream impedance of the umbilical artery. The indices commonly calculated include the umbilical artery systolic-diastolic (S/D) ratio, resistance index (RI), and pulsatility index (PI). Following the evaluation, the physician reviews the ultrasound imaging, calculates the relevant indices, assesses the umbilical artery blood flow velocity, and generates a written report summarizing the findings. It is important to note that for fetal Doppler velocimetry of the middle cerebral artery, a different code, CPT® Code 76821, is utilized, which involves similar procedural steps but focuses on the middle cerebral artery instead.
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The procedure of Doppler velocimetry, fetal; umbilical artery (CPT® Code 76820) is indicated for the following conditions:
The procedure of Doppler velocimetry involves several key steps to ensure accurate assessment of umbilical artery blood flow:
After the completion of the Doppler velocimetry procedure, the physician will typically review the results and discuss them with the patient. The findings may influence clinical decisions regarding the management of the pregnancy, including the timing of labor induction if indicated. Patients may be monitored for any signs of complications, and follow-up appointments may be scheduled to ensure ongoing assessment of fetal well-being. It is important for the healthcare provider to communicate any necessary follow-up actions or additional testing that may be required based on the results of the Doppler velocimetry.
| Short Descr | UMBILICAL ARTERY ECHO | Medium Descr | DOPPLER VELOCIMETRY FETAL UMBILICAL ARTERY | Long Descr | Doppler velocimetry, fetal; umbilical artery | 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 | STV-Packaged Codes | ASC Payment Indicator | Packaged service/item; no separate payment made. | Type of Service (TOS) | 4 - Diagnostic Radiology | Berenson-Eggers TOS (BETOS) | I4B - Imaging/procedure - other | MUE | 3 | 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. | 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. | GC | This service has been performed in part by a resident under the direction of a teaching physician | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | 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. | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | 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 | 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 | GB | Claim being re-submitted for payment because it is no longer covered under a global payment demonstration | 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 | 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 | 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 |
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| 2005-01-01 | Added | First appearance in code book in 2005. |
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