How To Use CPT Code 76820

CPT 76820 describes the use of Doppler ultrasonography for fetal surveillance to determine the velocity of blood flow through the umbilical artery. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 76820?

CPT 76820 can be used to describe the use of Doppler ultrasonography to assess blood flow through the umbilical artery in a pregnant patient. This code is used when the provider performs this procedure to determine the velocity of blood flow and gather information about the timing of labor induction or the need for fetal transfusion in cases of severe fetal anemia.

2. Official Description

The official description of CPT code 76820 is: ‘Doppler velocimetry, fetal; umbilical artery.’

3. Procedure

1. The provider applies gel to an ultrasound transducer probe.
2. The provider moves the transducer over the pregnant patient’s abdomen while gently pressing on it.
3. The transducer emits high-frequency sound waves and transmits the echoes back to a computer.
4. The computer interprets the echoes as images, which the provider uses to assess blood flow through the umbilical artery.

4. Qualifying circumstances

CPT 76820 is used when the provider needs to assess blood flow through the umbilical artery in a pregnant patient. This procedure is typically performed when there is a need to determine the timing of labor induction or when fetal anemia is severe enough to require a transfusion. It is important to note that this code specifically applies to the assessment of the umbilical artery and not other vessels.

5. When to use CPT code 76820

CPT code 76820 should be used when the provider performs Doppler ultrasonography to assess blood flow through the umbilical artery in a pregnant patient. It is important to ensure that the procedure is specifically focused on the umbilical artery and not other vessels. This code should not be used for other types of Doppler studies or for assessing blood flow in non-pregnant patients.

6. Documentation requirements

To support a claim for CPT 76820, the provider must document the following information:

• Reason for performing the procedure, such as the need to determine the timing of labor induction or the severity of fetal anemia
• Details of the procedure, including the use of gel, the placement of the transducer, and the interpretation of the images
• Any additional findings or observations made during the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 76820, ensure that the procedure is focused on assessing blood flow through the umbilical artery in a pregnant patient. It is important to use the appropriate CPT code for the professional or technical component, depending on the provider’s role in the procedure. Modifier 26 should be appended to the radiology code if reporting only the physician’s interpretation, while modifier TC should be appended if reporting only the technical component. However, payer policies may exempt hospitals from appending modifier TC. If the provider renders both the professional and technical components, no modifier is necessary for reporting a global service.

8. Historical information

CPT 76820 was added to the Current Procedural Terminology system on January 1, 2005. There have been no updates to the code since its addition.

9. Examples

1. A provider performs Doppler ultrasonography to assess blood flow through the umbilical artery in a pregnant patient to determine the timing of labor induction.
2. A provider uses Doppler velocimetry to assess blood flow through the umbilical artery in a pregnant patient with severe fetal anemia, to determine the need for a transfusion.
3. A provider performs Doppler ultrasonography to assess blood flow through the umbilical artery in a pregnant patient with a high-risk pregnancy, to monitor fetal well-being.
4. A provider uses Doppler velocimetry to assess blood flow through the umbilical artery in a pregnant patient with suspected placental insufficiency, to guide management decisions.
5. A provider performs Doppler ultrasonography to assess blood flow through the umbilical artery in a pregnant patient with intrauterine growth restriction, to monitor fetal growth and well-being.
6. A provider uses Doppler velocimetry to assess blood flow through the umbilical artery in a pregnant patient with preeclampsia, to monitor fetal well-being and guide management decisions.
7. A provider performs Doppler ultrasonography to assess blood flow through the umbilical artery in a pregnant patient with gestational diabetes, to monitor fetal well-being and guide management decisions.
8. A provider uses Doppler velocimetry to assess blood flow through the umbilical artery in a pregnant patient with a history of stillbirth, to monitor fetal well-being and provide reassurance.
9. A provider performs Doppler ultrasonography to assess blood flow through the umbilical artery in a pregnant patient with a suspected placental abruption, to guide management decisions.
10. A provider uses Doppler velocimetry to assess blood flow through the umbilical artery in a pregnant patient with a multiple gestation, to monitor fetal well-being and guide management decisions.