• 1.  76811 and 93325 or 76827

    Posted 04-04-2023 17:27

    If you find or suspect a heart defect on a 76811, but you are going to have to schedule the full fetal echo at a later date is it reasonable to bill 93325 or 76827 as we would be doing color flow/spectral doppler on that day to get the best diagnosis for the patient? Or are those codes included in the 76811? Alternatively, what if you suspect renal atresia and use color flow to evaluate the renal arteries would that be 93325. Basically, if there is a concern on the ultrasound that would usually be evaluated by color flow or spectral doppler should those be billed? We bill those codes for Echo but never on a 76811. Clearly we use color flow on all our anatomy scans, and will often use spectral doppler. 

    Sarah Anderson

  • 2.  RE: 76811 and 93325 or 76827

    Posted 04-06-2023 09:46

    Hi Sarah,
    This is a common question received by the coding committee. CPT code 93325 may only be billed as an add-on to the "parent" codes listed in the CPT manual, which are all echo codes (76825, 76826, 76827, 76828, 93303, 93304, 93308, 93312, 93314, 93315, 93317, 93350, and 93351). As such, it cannot be used with 76811. Any color flow used with 76811 would be included in the work associated with it.

    Fadi BSAT, MD, FAIUM
    Chair, SMFM Practice Management Committee
    Past Chair, SMFM Coding Committee