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The CPT® Code 76828 refers to a specific type of diagnostic imaging procedure known as fetal Doppler echocardiography. This procedure utilizes both pulsed wave and continuous wave Doppler techniques, accompanied by a spectral display, to assess the cardiovascular health of a fetus during pregnancy. The primary purpose of this echocardiography is to monitor and evaluate the unborn baby for potential cardiovascular anomalies. Such evaluations are particularly critical in cases where there is a known family history of congenital heart disease, or when an obstetrician has identified an abnormal fetal heart rhythm during routine examinations. Additionally, this procedure is indicated when anomalies of the heart or other major organ systems have been observed in previous ultrasounds, or if the mother has conditions such as Type I diabetes, or has been exposed to medications during pregnancy that could adversely affect fetal heart development. Abnormal results from an amniocentesis may also warrant this follow-up study. The procedure can be performed using either abdominal or transvaginal ultrasound techniques. In the abdominal approach, a gel is applied to the abdomen, and a transducer probe is moved across the skin to capture images from various angles. Conversely, the transvaginal method involves the insertion of a transducer into the vagina to obtain clearer images of the fetal heart. The Doppler technique is integral to this procedure, as it allows for the evaluation and measurement of blood flow through the heart's chambers and valves, providing critical information about the heart's function. This includes assessing the volume of blood pumped from each chamber with each heartbeat and identifying any abnormal blood flow patterns within the heart. Furthermore, the procedure can help detect structural anomalies, such as defects in the atrial or ventricular septum and issues with the heart valves. For initial complete studies, the CPT® Code 76827 should be used, while CPT® Code 76828 is designated for follow-up or repeat studies.
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The fetal Doppler echocardiography procedure, represented by CPT® Code 76828, is indicated for several specific clinical scenarios, particularly when there are concerns regarding the fetal cardiovascular system. The following conditions may warrant this follow-up or repeat study:
The procedure for fetal Doppler echocardiography, as described by CPT® Code 76828, involves several key steps to ensure accurate assessment of the fetal heart. The following outlines the procedural steps:
After the fetal Doppler echocardiography procedure, there are several considerations for post-procedure care and follow-up. Patients may be monitored briefly to ensure there are no immediate complications or discomfort following the ultrasound. The physician will review the results of the echocardiography and discuss any findings with the patient, including the need for further testing or monitoring if abnormalities are detected. Depending on the results, additional follow-up studies may be scheduled to continue monitoring the fetal heart health. It is also important for the patient to maintain regular prenatal care appointments to ensure comprehensive monitoring of both maternal and fetal health throughout the pregnancy.
| Short Descr | ECHO EXAM OF FETAL HEART | Medium Descr | DOPPLER ECHO FETAL PULS SPECTRAL F/U/REPEAT | Long Descr | Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study | 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) | I3B - Echography/ultrasonography - abdomen/pelvis | MUE | 2 | CCS Clinical Classification | 193 - Diagnostic ultrasound of heart (echocardiogram) |
This is a primary code that can be used with these additional add-on codes.
| 93325 | Addon Code MPFS Status: Active Code APC N PUB 100 CPT Assistant Article Doppler echocardiography color flow velocity mapping (List separately in addition to codes for echocardiography) |
| XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | 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. | 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 | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2005-01-01 | Changed | Code description changed. |
| 1993-01-01 | Added | First appearance in code book in 1993. |
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