2025 CPT code 76988
Intraoperative epicardial cardiac ultrasound (echocardiography) for congenital heart disease; placement, manipulation of transducer, and image acquisition only.
Modifiers 26 (professional component) and TC (technical component) may be applicable depending on the billing arrangement and the provider's role.Consult the official CPT manual and payer specific guidelines for proper modifier use.
Medical necessity for 76988 is established when intraoperative visualization of the cardiac structures is deemed necessary for safe and effective surgical management of the congenital heart disease.This may be due to the complexity of the case, the need for real-time guidance during surgery, or the potential for unforeseen complications.
The cardiothoracic surgeon or a qualified sonographer under the surgeon's supervision is responsible for performing this procedure. This includes proper placement of the ultrasound transducer, appropriate manipulation to obtain optimal images, and the acquisition of the images themselves. The interpretation and report are billed separately under code 76989.
- Radiology Procedures > Diagnostic Ultrasound Procedures
- Radiology Procedures > Diagnostic Ultrasound Procedures > Other Diagnostic Ultrasound Procedures
In simple words: During heart surgery to correct a birth defect, the doctor uses an ultrasound machine to take pictures of the heart's surface. This code covers only the steps of setting up the ultrasound and taking the pictures.
This CPT code, 76988, reports the intraoperative diagnostic ultrasound of the epicardial surface of the heart during a cardiac procedure to assess for congenital heart disease.The code encompasses the placement and manipulation of the ultrasound transducer, along with image acquisition.It does *not* include the interpretation and reporting of the images.A separate code, 76989, is used for this purpose.The procedure requires a sterile technique and the use of sterile coupling gel or saline.
Example 1: During a complex cardiac surgery for tetralogy of Fallot, intraoperative ultrasound is used to guide surgical repair, identify any additional defects not seen preoperatively, and confirm complete repair before closing the chest., In a patient with transposition of the great arteries, intraoperative ultrasound is used during the arterial switch operation to assess the position of the vessels and guide the creation of anastomoses., During the repair of an atrial septal defect, intraoperative ultrasound assesses the completeness of the closure and identifies any residual shunts.
Complete operative report detailing the procedure, including the indication for intraoperative echocardiography. The report should specifically detail the use of 76988, noting placement, manipulation of transducer, and image acquisition.Images obtained should be permanently stored in the patient's medical record.
** This code is specifically for image acquisition and does not include interpretation.Always ensure that the appropriate codes are used for each component of the service provided.
- Revenue Code: I3C (ECHOGRAPHY - HEART)
- RVU: RVUs for this code will vary based on geographic location, facility type (non-facility vs. facility), and other factors.Consult the appropriate Relative Value File (RVU) for specific payment information.
- Payment Status: Active
- Modifier TC rule: The TC modifier may be used if only the technical component (image acquisition) is performed, and the professional component (interpretation) is billed separately using code 76989.
- Fee Schedule: Fee schedules for this code are newly established in 2024, so there is no prior historical data.
- Specialties:Cardiothoracic Surgery, Cardiology, Radiology
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center