Use 76828 for follow-up or repeat Doppler interrogation of the fetal heart after an initial complete Doppler study. It typically appears alongside the follow-up echo 76826 in serial surveillance of a known cardiac finding. The initial complete Doppler study is 76827.
Report 76828 when cardiac Doppler is repeated to track a known finding: valve regurgitation being watched for progression, flow across an evolving lesion, or hemodynamic response of an arrhythmia to therapy. The study is focused on interval change in flow, and it inherits its medical necessity from the finding established on the initial evaluation. Like the rest of the fetal echo family, it is specialist territory, and payer credentialing policies follow the primary codes.
Documentation checklist
Anchor every follow-up Doppler to the baseline flow findings and state what changed.
✓Initial Doppler study referenced with date and findings
✓The flow abnormality or hemodynamic question under surveillance stated
✓Repeat spectral and color flow findings documented
✓Interval change characterized against baseline
✓Management implications noted where they drive the study interval
✓Waveforms and images stored
✓Signed interpretation with comparison statement
Global package rules
76828 is billed outside the global obstetric package and separately from 59400. It pairs naturally with 76826 on follow-up visits, with each component separately documented. Serial claims across gestation are expected for actively managed cardiac findings; keep the specific cardiac diagnosis on every claim rather than a generic screening code. NCCI
TC-26 components
Component billing mirrors the rest of the echo family: modifier 26 for the interpreting specialist, TC for the facility that owns the equipment.
76828
Global: one entity owns equipment and interpretation
76828-26
Professional: interpretation only
76828-TC
Technical: equipment and sonographer
Reimbursement
2026 · national Medicare averages
Component
Work RVU
Total RVU
2026 rate
76828Global
0.55
1.48
$49.43
76828-26Professional
0.55
0.80
$26.72
76828-TCTechnical
0.00
0.68
$22.71
National amounts under the 2026 Medicare Physician Fee Schedule (non-facility total RVU x $33.4009 conversion factor, no locality/MAC adjustment). Commercial and Medicaid rates differ. Verify current values with your MAC before billing.
Common denials
CO-B15No initial Doppler study on record
Why it happens
The payer found no baseline 76827 to support a follow-up code.
How to fix
Reference the initial study's date and findings in the report. If it was performed elsewhere, obtain the record and cite it on appeal.
Source: CMS
CO-50No ongoing indication for repeat Doppler
Why it happens
The claim lacked a diagnosis showing what flow abnormality is being tracked.
How to fix
Use the specific cardiac diagnosis under surveillance and make the interval-change question explicit in the report.
Source: ACOG/SMFM
CO-151Surveillance frequency exceeded
Why it happens
Serial follow-up claims crossed the payer's utilization screen.
How to fix
Appeal with the management plan; frequent reassessment is supported for arrhythmias on therapy and evolving lesions. Include the trend documentation.
Source: ACOG/SMFM
CO-23676828 and 76827 on the same date
Why it happens
Initial and follow-up Doppler codes were both reported for one session.
How to fix
Bill one code per session: 76827 for the initial complete study, 76828 for reassessments.
Source: NCCI
FAQ
What is the CPT code description for 76828?
In plain language, 76828 covers repeat Doppler evaluation of blood flow in the fetal heart, performed to track a known flow abnormality or monitor treatment response after an initial complete Doppler echocardiogram.
Is 76828 billed with 76826?
Usually, yes. A follow-up visit that repeats both the structural assessment and the Doppler interrogation bills 76826 plus 76828, each separately documented.
Can 76828 be the only code on a follow-up visit?
Yes, when only the Doppler assessment is repeated, for example flow surveillance of a known regurgitant valve without a full structural re-survey.
How often can 76828 be billed?
As often as the finding requires, commonly weekly for an arrhythmia on transplacental therapy. Document interval change on each study and expect frequency screens on long series.
Do specialty restrictions apply to 76828?
Yes. Payers that limit fetal echocardiography to MFM or pediatric cardiology apply the same rule across the family, follow-up Doppler included.
Is 76828 part of the global OB package?
No. Fetal cardiac imaging is billed separately from 59400.
CPT® is a registered trademark of the American Medical Association. Educational reference only, not billing, legal, or medical advice.
Maintained by Ouma Health, a maternal-fetal telemedicine practice. Printed from obcodingguide.com, content current as of July 2026.