How To Use CPT Code 76812

CPT 76812 describes the detailed ultrasound examination of an additional fetus during a transabdominal ultrasound procedure. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 76812?

CPT 76812 can be used to describe the detailed ultrasound examination of an additional fetus during a transabdominal ultrasound procedure. This code is used when the provider performs a thorough evaluation of each additional fetus apart from the routine fetal and maternal examination.

2. Official Description

The official description of CPT code 76812 is: ‘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).’ This code should be used in conjunction with CPT code 76811 for the ultrasound examination of the first fetus.

3. Procedure

1. After performing an ultrasound examination of the first fetus, the provider performs a detailed ultrasound examination of each additional fetus during the same session.
2. The provider applies gel to the ultrasound transducer head and places it over the patient’s abdomen.
3. The provider slowly moves the transducer over the mother’s abdomen, capturing images of the developing fetus and female pelvic structures.
4. During the detailed examination, the provider evaluates the number of fetuses, amniotic sacs, and age of each additional fetus.
5. The provider examines the brain, heart, extremities, and other organs in detail for each additional fetus.

4. Qualifying circumstances

CPT 76812 is used when the provider performs a detailed ultrasound examination of an additional fetus during a transabdominal ultrasound procedure. This code is applicable when there is more than one fetus present and the provider needs to evaluate each fetus individually. It is important to note that this code should only be used in addition to the primary procedure code for the ultrasound examination of the first fetus.

5. When to use CPT code 76812

CPT code 76812 should be used when the provider performs a detailed examination of each additional fetus apart from the routine fetal and maternal examination. This code is not appropriate for the examination of the first fetus, as it is already covered by CPT code 76811. It is important to report both codes together to accurately reflect the services provided.

6. Documentation requirements

To support a claim for CPT 76812, the provider must document the following information:

• The number of fetuses present
• The amniotic sacs and age of each additional fetus
• A detailed examination of the brain, heart, extremities, and other organs for each additional fetus
• Date and time of the ultrasound procedure
• Signature of the provider performing the ultrasound examination

7. Billing guidelines

When billing for CPT 76812, ensure that the provider has also reported CPT code 76811 for the ultrasound examination of the first fetus. This is an add-on code, and it should not be reported without the appropriate primary code. If reporting only the physician’s interpretation for the radiology service, append modifier 26 to the radiology code. If reporting only the technical component, append modifier TC to the radiology code. However, be aware that payer policies may exempt hospitals from appending modifier TC. When reporting a global service in which one provider renders both the professional and technical components, do not append a professional or technical modifier to the radiology code.

8. Historical information

CPT 76812 was added to the Current Procedural Terminology system on January 1, 2003. There have been no updates to the code since its addition.

9. Examples

1. A provider performs a transabdominal ultrasound and evaluates the first fetus in detail. During the same session, the provider also performs a detailed examination of an additional fetus using CPT code 76812.
2. After performing a routine ultrasound examination of the first fetus, the provider performs a detailed examination of each additional fetus during a transabdominal ultrasound procedure using CPT code 76812.
3. A pregnant patient undergoes a transabdominal ultrasound, and the provider performs a detailed examination of each additional fetus present, documenting the findings with CPT code 76812.
4. During a transabdominal ultrasound procedure, the provider evaluates the first fetus and then performs a detailed examination of each additional fetus using CPT code 76812.
5. A provider performs a transabdominal ultrasound and thoroughly examines each additional fetus present, reporting the services with CPT code 76812.
6. After conducting a routine ultrasound examination of the first fetus, the provider performs a detailed examination of each additional fetus during a transabdominal ultrasound procedure, utilizing CPT code 76812.
7. During a transabdominal ultrasound, the provider evaluates the first fetus and then performs a detailed examination of each additional fetus using CPT code 76812.
8. A pregnant patient undergoes a transabdominal ultrasound, and the provider performs a detailed examination of each additional fetus present, documenting the findings with CPT code 76812.
9. After performing a routine ultrasound examination of the first fetus, the provider performs a detailed examination of each additional fetus during a transabdominal ultrasound procedure using CPT code 76812.
10. A provider performs a transabdominal ultrasound and thoroughly examines each additional fetus present, reporting the services with CPT code 76812.