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The CPT® Code 76812 refers to a specific type of obstetric ultrasound procedure known as a real-time transabdominal ultrasound. This procedure is performed on a pregnant uterus and includes comprehensive image documentation. The primary purpose of this ultrasound is to evaluate both fetal and maternal conditions, with a particular focus on a detailed anatomical examination of the fetus. During the procedure, the healthcare provider assesses various aspects of the fetus, including its viability, gestational age, and anatomical structures. This evaluation is crucial for identifying multiple gestations, determining the position of the fetus and placenta, and surveying the fetal anatomy, which encompasses critical areas such as the brain, spine, abdomen, and heart. The procedure also involves evaluating the umbilical cord insertion site and assessing the volume of amniotic fluid, as well as examining the maternal uterus and adnexa when visible. To conduct the ultrasound, the mother is typically required to have a full bladder, which aids in obtaining clearer images. Acoustic coupling gel is applied to the skin of the lower abdomen, and a transducer is used to capture images by emitting ultrasonic wave pulses. These waves reflect off the fetus and surrounding structures, allowing for the visualization of any abnormalities. After the procedure, the physician reviews the captured images and provides a written interpretation of the findings. It is important to note that this code is specifically designated for each additional gestation in a multiple pregnancy, while code 76811 is used for the first gestation or a single gestation evaluation.
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The CPT® Code 76812 is indicated for use in various clinical scenarios related to obstetric evaluations. The following conditions or situations may warrant the performance of this ultrasound procedure:
The procedure for CPT® Code 76812 involves several key steps that ensure a comprehensive evaluation of the pregnant uterus and fetus. The following outlines the procedural steps:
Following the completion of the ultrasound procedure coded as CPT® 76812, the patient may be provided with specific post-procedure care instructions. Typically, there are no significant restrictions or recovery requirements following this non-invasive procedure. The physician will discuss the findings with the patient, including any necessary follow-up actions based on the ultrasound results. If any abnormalities are detected, further diagnostic testing or monitoring may be recommended. The patient is encouraged to reach out to their healthcare provider with any questions or concerns regarding the results or subsequent steps in their care.
| Short Descr | OB US DETAILED ADDL FETUS | Medium Descr | US PREG UTERUS DETAIL FETAL ANAT EXAM EA GESTAT | Long Descr | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (List separately in addition to code for primary procedure) | Status Code | Active Code | Global Days | ZZZ - Code Related to Another Service | 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 | 01 - Procedure must be performed under the general supervision of a physician. | 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 | Items and Services Packaged into APC Rates | ASC Payment Indicator | Packaged service/item; no separate payment made. | Type of Service (TOS) | 4 - Diagnostic Radiology | Berenson-Eggers TOS (BETOS) | I3B - Echography/ultrasonography - abdomen/pelvis | MUE | 2 | CCS Clinical Classification | 197 - Other diagnostic ultrasound |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 76811 | Female Edit MPFS Status: Active Code APC S ASC Z3 PUB 100 CPT Assistant Article Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation |
| 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. | 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. | CR | Catastrophe/disaster related | GC | This service has been performed in part by a resident under the direction of a teaching physician | 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 | 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 | 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. |
| 2003-01-01 | Added | First appearance in code book in 2003. |
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