Ob-Gyn Coding Alert

Question: Fetal cardiac evaluation was performed using 2D ultrasound, color Doppler, M-mode and pulse wave Doppler.

Exam Findings: Our findings indicate that the fetal heart appears to be within normal limits for position, size, structure, function and rhythm. Specifically, the four chamber, venous inflow and ventricular outflow tract views of the heart are seen to be in normal position. The chamber size and cardiac function are within normal limits for this fetal age. The right ventricular outflow tract was seen arising from the conus, splitting into two PAs and then the ductus. Crossover of the great vessels is observed. The pulmonary veins are seen entering the left atrium. The aortic and ductal arches appear to be normal in size and position.

Rate/Rhythm: The heart rate and rhythm are normal throughout the study.

Doppler Exam: The E/A ratios of both A/V valves are within normal limits. Interrogation of the semilunar valves shows normal peak velocities as well as acceleration times. There is no evidence of leakage of the valves.

Color Flow: There is normal directional flow through the great vessels and outflow tracts; no reversal or turbulent flow seen. Normal right-to-left shunting across the foramen ovale is observed.

What should I report for this?

Connecticut Subscriber

Answer: You should report 76827 (Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete), as this code matches the work performed. You may also report +93325 (Doppler echocardiography color flow velocity mapping [List separately in addition to codes for echocardiography]) per the instructions in CPT^®.