How To Use CPT Code 76825

CPT 76825 describes the use of real-time fetal echocardiography, with or without M-mode recording, to evaluate the fetal cardiovascular system. 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 76825?

CPT 76825 can be used to describe the use of real-time fetal echocardiography, with or without M-mode recording, to evaluate the fetal cardiovascular system. This code is used when a provider or sonographer applies gel on the ultrasound transducer and slides it over the pregnant patient’s abdomen to obtain 2D images of the fetal heart. The provider then evaluates the entire cardiovascular system of the fetus in real time.

2. Official Description

The official description of CPT code 76825 is: ‘Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording.’

3. Procedure

1. The provider or sonographer applies gel on the ultrasound transducer and slides it over the pregnant patient’s abdomen.
2. The transducer sends high-frequency sound waves through the abdomen to the fetus and picks up the return echoes.
3. A computer converts the echoes into 2D images of the fetal heart.
4. The provider evaluates the entire cardiovascular system of the fetus in real time.
5. M-mode imaging may or may not be performed to assess moving structures, such as the heart valves.

4. Qualifying circumstances

CPT 76825 is used when a complete evaluation of the fetal cardiovascular system is performed using real-time fetal echocardiography, with or without M-mode recording. This code is applicable to pregnant patients who require an assessment of the fetal heart and blood vessels.

5. When to use CPT code 76825

CPT code 76825 should be used when a provider performs real-time fetal echocardiography, with or without M-mode recording, to evaluate the fetal cardiovascular system. It is important to note that this code should not be reported for repeat fetal echocardiography studies, as there is a separate code (CPT 76826) for that purpose.

6. Documentation requirements

To support a claim for CPT 76825, the provider must document the following information:

• Indication for the fetal echocardiography study
• Use of gel and ultrasound transducer on the patient’s abdomen
• Performance of real-time imaging and evaluation of the fetal cardiovascular system
• Inclusion or exclusion of M-mode recording
• Any additional findings or observations during the procedure

7. Billing guidelines

When billing for CPT 76825, ensure that the procedure involves real-time fetal echocardiography, with or without M-mode recording. It is important to append the appropriate modifiers (e.g., modifier 26 for professional component or modifier TC for technical component) if only reporting the interpretation or technical portion of the service. However, note that payer policies may exempt hospitals from appending modifier TC. If the provider renders both the professional and technical components, no modifiers are necessary for reporting the global service.

8. Historical information

CPT 76825 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A provider performs real-time fetal echocardiography to evaluate the fetal cardiovascular system and documents the findings.
2. A sonographer applies gel on the ultrasound transducer and obtains 2D images of the fetal heart during a fetal echocardiography study.
3. A provider uses real-time fetal echocardiography with M-mode recording to assess the fetal heart valves and blood flow.
4. A pregnant patient undergoes real-time fetal echocardiography to evaluate the entire cardiovascular system of the fetus.
5. A provider performs real-time fetal echocardiography without M-mode recording to assess the fetal heart chambers and structures.
6. A sonographer obtains 2D images of the fetal heart using real-time fetal echocardiography and documents any abnormalities.
7. A provider evaluates the fetal cardiovascular system in real time during a fetal echocardiography study with M-mode recording.
8. A pregnant patient undergoes real-time fetal echocardiography to assess the fetal heart rate and rhythm.
9. A sonographer applies gel on the ultrasound transducer and performs real-time fetal echocardiography to evaluate the fetal heart valves.
10. A provider uses real-time fetal echocardiography without M-mode recording to assess the fetal blood vessels and circulation.