2025 HCPCS code C8921
Transthoracic echocardiography with contrast, or without contrast followed by contrast, for congenital cardiac anomalies; complete.
Medical necessity for C8921 must be supported by the presence of signs, symptoms, or other clinical findings suggestive of congenital cardiac anomalies. The documentation should clearly demonstrate the need for a complete echocardiographic evaluation with contrast to establish a diagnosis, guide treatment decisions, or monitor the patient's condition.
In simple words: This is a special ultrasound of the heart done to look for birth defects. A gel is put on your chest, and a small device is moved around to take pictures of your heart. Sometimes a dye is injected into your vein to make the pictures clearer. This helps the doctor see how your heart is working and if there are any problems present from birth.
This code represents a complete transthoracic echocardiography (TTE) study performed with contrast, or initially without contrast and subsequently with contrast, specifically for the evaluation of congenital cardiac anomalies. A conductive gel is applied to the patient's chest, and a transducer is used to capture and display real-time images of the heart. Contrast material may be injected intravenously to enhance the visualization of cardiac structures and blood flow, especially when standard ultrasound waves are obstructed by lung tissue, ribs, or other anatomical structures. This procedure allows for detailed assessment of heart movement, blood flow through vessels and valves, and identification of congenital abnormalities.
Example 1: A newborn infant presents with cyanosis and a heart murmur. A transthoracic echocardiogram with contrast (C8921) is ordered to evaluate for suspected congenital heart disease, which is confirmed by the visualization of a ventricular septal defect., A pediatric patient with a history of atrial septal defect is scheduled for a follow-up TTE. Initially, the echocardiogram is performed without contrast, but due to suboptimal visualization of the defect, contrast is administered, and the study is completed (C8921) to thoroughly assess the defect's size and any changes., A teenager experiences shortness of breath during exercise. A transthoracic echocardiogram is performed without contrast to assess cardiac function, which is inconclusive. The cardiologist give a contrast injection, completing the study (C8921) to exclude any congenital abnormalities or other cardiac conditions, providing a definitive diagnosis and guiding treatment decisions.
Documentation should include the indication for the echocardiogram, such as signs, symptoms, or prior diagnostic findings suggesting congenital cardiac anomalies. The type of contrast agent used (if any), and a detailed interpretation of the echocardiographic images, including specific measurements and descriptions of any abnormalities, should be recorded. The report should also clearly state that the study was “complete” to justify the use of C8921.
- Specialties:Pediatric Cardiology, Congenital Heart Surgery, Cardiology
- Place of Service:Outpatient Hospital, Ambulatory Surgical Center, Independent Clinic