CPT® Code 76946

1. Indications

Amniocentesis, guided by ultrasound, is indicated for several specific conditions and assessments during pregnancy. The following are the primary indications for performing this procedure:

• Fetal Chromosome Disorders Amniocentesis is performed to identify the presence of chromosomal abnormalities in the fetus, such as Down syndrome.
• Structural Defects The procedure is utilized to detect structural anomalies, including but not limited to spina bifida and anencephaly.
• Inherited Disorders It is also indicated for the evaluation of various inherited disorders that may affect the fetus.
• Rh Incompatibility Later in pregnancy, amniocentesis can be used to assess Rh incompatibility between the mother and fetus.
• Infection Evaluation The procedure may be indicated to check for infections that could impact fetal health.
• Lung Maturity Assessment Amniocentesis can be performed to evaluate the maturity of the fetal lungs, which is critical for planning delivery.

2. Procedure

The procedure for ultrasonic guidance during amniocentesis involves several critical steps to ensure safety and accuracy. The following outlines the procedural steps:

• Step 1: Initial Ultrasound Examination Before the amniocentesis, an abdominal ultrasound is conducted to visualize the pregnant uterus. This step is crucial for determining the position of the fetus and locating the placenta, which helps in planning the safest approach for needle insertion.
• Step 2: Evaluation of Amniotic Fluid During the ultrasound, the physician evaluates the level of amniotic fluid and identifies a suitable pocket of fluid for sampling. This assessment is vital to ensure that the needle can be accurately placed in the correct location.
• Step 3: Continuous Ultrasound Monitoring Once the appropriate pocket of amniotic fluid is located, continuous ultrasound imaging is utilized throughout the procedure. This real-time monitoring allows the physician to guide the needle precisely into the amniotic fluid pocket, minimizing the risk of injury to the fetus or placenta.
• Step 4: Aspiration of Amniotic Fluid After confirming the correct needle placement, the physician aspirates a sample of the amniotic fluid. This fluid is then sent for laboratory analysis to assess for any genetic or structural abnormalities.
• Step 5: Documentation Following the completion of the procedure, the physician prepares a written report detailing the imaging component of the amniocentesis. This report is essential for medical records and further patient management.

3. Post-Procedure

After the amniocentesis procedure, patients are typically monitored for any immediate complications. It is common for healthcare providers to advise patients to rest and avoid strenuous activities for a short period following the procedure. Patients may be informed about potential side effects, such as mild cramping or spotting, which can occur after the procedure. Additionally, follow-up appointments may be scheduled to discuss the results of the amniotic fluid analysis and to monitor the health of both the mother and fetus. It is important for patients to report any unusual symptoms, such as heavy bleeding or severe abdominal pain, to their healthcare provider promptly.