How To Use CPT Code 76821

CPT code 76821 describes the use of Doppler ultrasonography for fetal surveillance to determine the velocity of blood flow through the middle cerebral 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 76821?

CPT 76821 can be used to describe the use of Doppler ultrasonography to assess the blood flow through the middle cerebral artery of a fetus. This code is used to determine the timing of labor induction and to identify severe fetal anemia that may require a transfusion.

2. Official Description

The official description of CPT code 76821 is: ‘Doppler velocimetry, fetal; middle cerebral artery.’

3. Procedure

1. The sonographer applies gel to an ultrasound transducer probe and gently presses it on the pregnant patient’s abdomen.
2. The transducer emits high-frequency sound waves that penetrate the tissues and bounce back as echoes.
3. The echoes are then transmitted to a computer, which interprets them as images.
4. The provider uses these images to assess the blood flow through the middle cerebral artery of the fetus.

4. Qualifying circumstances

CPT 76821 is performed when there is a need to evaluate the blood flow through the middle cerebral artery of the fetus. This test is typically done to determine the timing of labor induction or to assess the severity of fetal anemia that may require a transfusion.

5. When to use CPT code 76821

CPT code 76821 should be used when there is a need to assess the blood flow through the middle cerebral artery of the fetus. It is important to ensure that the test is medically necessary and meets the criteria for reimbursement.

6. Documentation requirements

To support a claim for CPT 76821, the provider must document the following information:

• Reason for performing the test, such as the need to determine the timing of labor induction or assess fetal anemia
• Date and time of the procedure
• Images or findings from the Doppler ultrasonography
• Interpretation of the results
• Signature of the provider performing the test

7. Billing guidelines

When billing for CPT 76821, it is important to ensure that the test is performed by a qualified provider and meets the criteria for reimbursement. Modifier 26 should be appended to the radiology code if only the physician’s interpretation is being reported. Modifier TC should be appended if only the technical component is being reported. However, payer policies may exempt hospitals from appending modifier TC. If both the professional and technical components are rendered by one provider, no modifier is necessary.

8. Historical information

CPT 76821 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 the blood flow through the middle cerebral artery of a fetus to determine the timing of labor induction.
2. A pregnant patient undergoes Doppler velocimetry to evaluate the blood flow through the middle cerebral artery of the fetus to assess the severity of fetal anemia.
3. A provider uses Doppler ultrasonography to assess the blood flow through the middle cerebral artery of a fetus to determine if a transfusion is necessary.
4. Doppler velocimetry is performed to evaluate the blood flow through the middle cerebral artery of a fetus to guide the management of a high-risk pregnancy.
5. A pregnant patient undergoes Doppler ultrasonography to assess the blood flow through the middle cerebral artery of the fetus to monitor fetal well-being.
6. A provider performs Doppler velocimetry to assess the blood flow through the middle cerebral artery of a fetus to determine the need for further interventions.
7. Doppler ultrasonography is used to evaluate the blood flow through the middle cerebral artery of a fetus to assess fetal growth and development.
8. A pregnant patient undergoes Doppler velocimetry to assess the blood flow through the middle cerebral artery of the fetus to monitor the effects of a medication on fetal circulation.
9. A provider performs Doppler ultrasonography to assess the blood flow through the middle cerebral artery of a fetus to guide the management of a complicated pregnancy.
10. Doppler velocimetry is performed to evaluate the blood flow through the middle cerebral artery of a fetus to assess the response to a therapeutic intervention.