How To Use CPT Code 76814

CPT 76814 describes the procedure for measuring the fetal nuchal translucency during the first trimester of pregnancy using ultrasound. 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 76814?

CPT 76814 is used to measure the fetal nuchal translucency, which is the clear, fluid-filled space at the back of the developing fetus’s neck, during the first trimester of pregnancy. This procedure is performed using ultrasound and can help diagnose any abnormalities or defects in the fetus’s chromosomes.

2. Official Description

The official description of CPT code 76814 is: ‘Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (List separately in addition to code for primary procedure).’ This code should be used in conjunction with CPT code 76813 for the ultrasound examination of the first fetus.

3. Procedure

1. The provider uses either a transabdominal or transvaginal ultrasound approach to measure the fetal nuchal translucency.
2. In the transabdominal approach, the provider applies gel on the ultrasound transducer head and places it on the patient’s lower abdomen. The transducer is then moved over the abdomen to obtain images.
3. In the transvaginal approach, the provider inserts a covered transducer into the vagina and performs an internal ultrasound. This approach provides clearer images of the fetus and maternal organs.
4. The ultrasound waves reflect through the tissues, and the receiving unit creates images of the nuchal translucency in the fetus.
5. If there are additional fetuses, CPT code 76814 should be used to measure the nuchal translucency for each additional fetus.

4. Qualifying circumstances

CPT 76814 is used when measuring the fetal nuchal translucency during the first trimester of pregnancy. It is typically performed to diagnose any abnormalities or defects in the fetus’s chromosomes. The procedure can be done using either a transabdominal or transvaginal approach, depending on the provider’s preference and the clarity of the images needed.

5. When to use CPT code 76814

CPT code 76814 should be used when measuring the fetal nuchal translucency during the first trimester of pregnancy. It is important to note that this code should only be reported in conjunction with CPT code 76813 for the ultrasound examination of the first fetus. It is an add-on code and should not be reported without an appropriate primary code.

6. Documentation requirements

To support a claim for CPT 76814, the provider must document the following information:

• Indication for the ultrasound examination
• Whether a transabdominal or transvaginal approach was used
• Date of the procedure
• Number of fetuses and the measurement of the nuchal translucency for each fetus
• Any additional findings or abnormalities observed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 76814, ensure that the procedure is performed during the first trimester of pregnancy and that the appropriate primary code (CPT 76813) is also reported. 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. Do not append a professional or technical modifier when reporting a global service where one provider renders both components.

8. Historical information

CPT 76814 was added to the Current Procedural Terminology system on January 1, 2007. There have been no updates to the code since its addition.

9. Examples

1. A provider measures the nuchal translucency of a fetus during the first trimester ultrasound examination.
2. During the ultrasound, the provider identifies an increased nuchal translucency measurement, indicating a potential chromosomal abnormality.
3. The provider performs a transvaginal ultrasound to obtain clearer images of the fetus and confirm the findings.
4. In another case, the provider measures the nuchal translucency of twins during the first trimester ultrasound examination.
5. The provider documents the measurements for each fetus separately using CPT code 76814.
6. During the ultrasound, the provider identifies a normal nuchal translucency measurement for both fetuses.
7. These examples demonstrate the appropriate usage of CPT code 76814 for measuring the fetal nuchal translucency during the first trimester of pregnancy.