Radiology Coding Alert

Reader Questions:

Know to Assign 76999 for a Ductus Venosus Doppler Study

Published on Tue Nov 22, 2022

Question: I have a report documenting the radiologist performed a ductus venosus doppler study only to assess the function of the fetal ductus venosus. I can’t find a listing for ductus venosus under the Doppler Scan section of the AMA CPT^®code set index.

How do I report this procedure?

Kansas Subscriber

Answer: You’ll assign 76999 (Unlisted ultrasound procedure (eg, diagnostic, interventional)) to report the procedure. There isn’t a code designated for a ductus venosus doppler study in the 2022 CPT^®code set nor the upcoming 2023 CPT^® code set, which means your only option is to select an unlisted ultrasound code.

Selecting the code is just a piece of the puzzle, as you’ll also need to include a special report. According to the AMA CPT^®Radiology guidelines, the special report should include the following information:

“Adequate definition or description of the nature, extent, and need for the procedure;
and the time, effort, and equipment necessary to provide the service.”

The special report shows the medical necessity for the procedure and indicates that the ductus venosus doppler study was performed alone.

Other CPT^® codes, such as 76827-76828 (Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display …), include a ductus venosus study as a part of the procedures. This means you cannot report a ductus venosus doppler study separately if you’re also reporting a fetal doppler echocardiography service.