CPT® Code 76988

Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; placement, manipulation of transducer, and image acquisition only

The CPT® Code 76988 refers to an intraoperative epicardial cardiac ultrasound, specifically designed for diagnostic purposes in patients with congenital heart disease. This procedure involves the use of an ultrasound probe that is strategically placed on the surface of the heart during cardiac surgery. The primary goal of this ultrasound is to assess the coronary arteries, particularly to determine which arteries may require bypass grafting. The procedure is typically performed during critical surgical interventions, such as cardiopulmonary bypass grafting, where real-time imaging is essential for making informed decisions regarding surgical targets.

During the procedure, an ultra-high frequency ultrasound probe is utilized, which is inserted into a sterile sheath that is pre-filled with saline or ultrasound transmission gel. This preparation ensures that all air is removed from the sheath, allowing for optimal transmission of ultrasound waves. The probe is then carefully introduced into the opened surgical field, enabling the operator to scan the surface anatomy of the native and diseased coronary arteries. The information gathered from these scans is crucial for developing an optimized surgical plan, as it helps identify the most appropriate graft targets based on the condition of the coronary arteries.

Throughout the scanning process, the probe operator is responsible for the insertion and manipulation of the ultrasound probe over the heart's surface. Simultaneously, an echocardiographer evaluates the images produced, documenting significant findings and communicating relevant observations to the cardiac surgeon. In some cases, a single echocardiographer may take on both roles, performing the scanning and evaluation tasks. Once the imaging is complete, the ultrasound probe is carefully removed from the surgical field, concluding the intraoperative assessment.