Basics of Cpt code 76801 & 76802

This is a diagnostic ultrasound imaging technique in which bouncing sound waves far above the level of human perception through interior body structures. The sound waves pass through different densities of tissue and reflect back to a receiving unit at varying speeds. The unit converts the waves to electrical pulses that are immediately displayed in picture form on screen. Real time scanning displays both two-dimensional structure images and movement with time. CPT code 76801 is reported for real time ultrasound, transabdominal, with image documentation on a pregnant uterus for fetal and maternal evaluation in the first trimester of a single or first gestation. This includes determining the number of fetuses and gestational sacs and taking their measurements, surveying the visible fetal and placental structure, assessing amniotic fluid volume and sac shape, and examining the maternal uterus and adnexa. CPT code 76802 is reported for each additional gestation evaluation.

Code description of CPT code 76801 & 76802

76801 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation
+76802 each additional gestation (List separately in addition to code for primary procedure)

CPT Code 76801 is reported for a single or first gestation. CPT Code 76802 is an add-on code that should be reported in conjunction with code 76801 for each additional gestation. A cross-reference has been added to direct coders to use code 76802 only in conjunction with code 76801 for the same date of service. If the ultrasound examination is performed on a pregnant female with twins, then code 76801 should be reported for the first twin (twin A) and 76802 should be reported for the second twin (twin B). 

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Use of CPT code 76805 & 76810

CPT code 76805 is reported for real time ultrasound, transabdominal, with image documentation on a pregnant uterus for fetal and maternal evaluation after the first trimester of a single or first gestation. This includes determining the number of fetuses and amniotic/chorionic sacs, taking measurements appropriate for gestational age, surveying intracranial, spinal, abdominal, and heart chamber anatomy as well as the insertion site of the umbilical cord and the location of the placenta, and assessing amniotic fluid and maternal adnexa. CPT code 76810 is reported for each additional gestation evaluation.

76805 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
+76810 each additional gestation (List separately in addition to code for primary procedure)

Codes 76801 and 76802 are used to report a transabdominal approach obstetrical ultrasound examination performed during the first trimester of pregnancy, which is defined as less than 14 weeks of gestation.

76801 – Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (<14 weeks 0 days), transabdominal approach; single or first gestation

Add-On Code 76802 each additional gestation (List separately in addition to code for primary procedure)

The above codes include determination of the number of gestational sacs and fetuses, gestational sac/fetal measurements appropriate for gestation (< 14 weeks 0 days). Measurements of mean gestational sac size crown-rump length are taken. In addition, a survey of visible fetal and placental anatomic structure, qualitative assessment of amniotic fluid volume/gestational sac shape and examination of the maternal uterus and adnexa is performed.

Code 76801 is reported for a single or first gestation. Code 76802 is an add-on code that should be reported in conjunction with code 76801 for each additional gestation. A cross-reference has been added to direct coders to use code 76802 only in conjunction with code 76801 for the same date of service. If the ultrasound examination is performed on a pregnant female with twins, then code 76801 should be reported for the first twin (twin A) and 76802 should be reported for the second twin (twin B). It would not be appropriate to append modifier-51 to code 76802, as addon codes are exempt from modifier -51.

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CPT code 76805 and 76810 include determination of number of fetuses and amniotic/chorionic sacs, measurements appropriate for gestational age (> or = 14 weeks 0 days), such as biparietal diameter head circumference, femur length and abdominal circumference, survey of intracranial/spinal/abdominal anatomy, four-chambered heart, umbilical cord insertion site, placenta location and amniotic fluid assessment and, when visible, examination of maternal adnexa. These codes include gray-scale real time images with image documentation and written interpretation.