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A real-time transabdominal obstetrical ultrasound, designated by CPT® Code 76805, is a diagnostic imaging procedure performed on a pregnant uterus to evaluate both fetal and maternal health after the first trimester, specifically at or beyond 14 weeks of gestation. This ultrasound technique utilizes high-frequency sound waves to create images of the fetus and the surrounding structures within the mother's pelvis. The procedure is essential for assessing various aspects of fetal development and maternal well-being. It helps establish the viability of the fetus, identifies the presence of multiple gestations, and determines fetal age through precise measurements. Additionally, the ultrasound evaluates the position of the fetus and placenta, surveys fetal anatomy—including critical structures such as the brain, spine, abdomen, and heart—and assesses the umbilical cord insertion site and amniotic fluid volume. The procedure requires the mother to have a full bladder, which aids in obtaining clearer images. During the ultrasound, acoustic coupling gel is applied to the lower abdomen, and a transducer is used to capture images by directing ultrasonic waves at the fetus and surrounding structures. The echoes from these waves are recorded to create detailed images, which are then reviewed by the physician for any abnormalities. A written interpretation of the findings is provided, ensuring comprehensive documentation of the procedure. CPT® Code 76805 is specifically utilized for a single gestation or the first gestation in cases of multiple pregnancies after the first trimester, while CPT® Code 76810 is designated for each additional gestation.
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Ultrasound, CPT® Code 76805, is indicated for the following conditions and evaluations:
The procedure for performing a transabdominal obstetrical ultrasound, CPT® Code 76805, involves several key steps:
After the completion of the ultrasound procedure, there are no specific post-procedure care requirements mentioned in the provided data. However, it is standard practice for the patient to be informed about the results of the ultrasound during a follow-up appointment. The physician may discuss any findings, potential concerns, or necessary follow-up actions based on the ultrasound results. The patient may resume normal activities immediately following the procedure unless otherwise advised by the healthcare provider.
| Short Descr | OB US >= 14 WKS SNGL FETUS | Medium Descr | US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION | Long Descr | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 1 - Diagnostic Tests for Radiology Services | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Procedure or Service, Not Discounted when Multiple | ASC Payment Indicator | Radiology service paid separately when provided integral to a surgical procedure on ASC list; payment based on OPPS relative payment weight. | Type of Service (TOS) | 4 - Diagnostic Radiology | Berenson-Eggers TOS (BETOS) | I3B - Echography/ultrasonography - abdomen/pelvis | MUE | 1 | CCS Clinical Classification | 197 - Other diagnostic ultrasound |
This is a primary code that can be used with these additional add-on codes.
| 76810 | Female Edit Addon Code MPFS Status: Active Code APC N ASC N1 PUB 100 CPT Assistant Article Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (List separately in addition to code for primary procedure) |
| 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | TC | Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | CR | Catastrophe/disaster related | GA | Waiver of liability statement issued as required by payer policy, individual case | GC | This service has been performed in part by a resident under the direction of a teaching physician | KX | Requirements specified in the medical policy have been met | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | X4 | Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2011-01-01 | Changed | Short description changed. |
| 2007-01-01 | Changed | Code description changed. |
| 2005-01-01 | Changed | Code description changed. |
| 2003-01-01 | Changed | Code description changed. |
| 2002-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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