CPT 76856, cpt code 76856, 76856 cpt code

CPT 76856 | Description, Procedure & Billing Guidelines (2022)

CPT code 76856 describes a non-invasive pelvic ultrasound procedure for male and female patients and is used to assess body parts in the pelvic area.

1. What Is CPT Code 76856?

CPT 76856 covers a non-invasive pelvic ultrasound procedure. It is used for the assessments of the following body parts in females;

  • the fallopian tubes;
  • the cervix;
  • the uterus;
  • the ovaries; and
  • the bladder

This non-invasive pelvic ultrasound procedure can also be used for male patients and can assess the following;

  • the seminal vesicles;
  • the prostate gland; and
  • the bladder.

The images made during the 76856 CPT code procedure can be displayed digitally or recorded permanently.

2. Description

CPT code 76856 is a procedural code described by the CPT book: “Ultrasound, pelvic (nonobstetric), real-time with image documentation; complete.”

3. Procedure

The 76856 CPT code procedure starts with a provider applying conductive gel on the patient’s pelvic region. The conductive gel improves the transmission of sound waves.

The ultrasound technician (or another health provider) uses an ultrasound machine during this procedure. This machine uses high–frequency sound waves for imaging and sends sound waves through the transducer.

The transducer is placed on the patient’s pelvic area and moved around, and images are displayed on a monitor or recorded for a permanent record.

4. Billing Guidelines

Use the CPT 76856 code for a complete ultrasound for examination of all the pelvic organs in female and male patients.

You may use CPT 76857 instead of this code if an ultrasound procedure of the bladder alone is performed.

Use CPT 76872 for a transrectal ultrasound to examine males’ prostate, rectum, and surrounding structures.

4.1 Can CPT 76856 And CPT 76830 Be Billed Together?

Yes, it is possible to bill CPT 76856 and CPT 76830 because there are no NCCI edits between these two codes.

Report CPT 76856 and CPT 76830 for Non-OB exams only.

4.3 What Is The Difference Between CPT 76857 And CPT 76856?

The difference between CPT 76857 and CPT 76856 is as follows. Bill CPT code 76856 if only the prostate is examined with a pelvic ultrasound.

CPT 76857, on the other hand, can be used for a complete pelvic ultrasound examination.

5. Resources

https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=56671

https://www.aetna.com/cpb/medical/data/500_599/0530.html

CPT Professional 2022

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