How To Use CPT Code 76830

CPT 76830 describes the diagnostic ultrasound procedure of the pelvis for non-obstetrical purposes. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 76830?

CPT 76830 is a code used to describe a diagnostic ultrasound procedure performed on the pelvis for non-obstetrical purposes. This procedure allows healthcare providers to assess the reproductive organs, including the uterus, fallopian tubes, ovaries, cervix, and vagina, in female patients.

2. Official Description

The official description of CPT code 76830 is: ‘Ultrasound, transvaginal.’

3. Procedure

1. During a transvaginal ultrasound, a qualified healthcare provider or ultrasound technician applies conductive gel over a condom that has been placed over the transducer.
2. The provider then moves the transducer around inside the vagina, using a small hand-held device that resembles a microphone.
3. The transducer emits high-frequency sound waves into the body, which bounce back as echoes from the reproductive organs.
4. These echoes are then converted into images that are displayed on a monitor, allowing the provider to assess the condition of the uterus, fallopian tubes, ovaries, cervix, and vagina.

4. Qualifying circumstances

CPT 76830 is used for non-obstetrical purposes, specifically to assess the reproductive organs in female patients. It is typically performed when there is a need to evaluate the condition of the uterus, fallopian tubes, ovaries, cervix, or vagina. This procedure is commonly used to diagnose conditions such as fibroids, ovarian cysts, endometriosis, and pelvic inflammatory disease.

5. When to use CPT code 76830

CPT code 76830 should be used when a transvaginal ultrasound is performed for non-obstetrical purposes to assess the reproductive organs in female patients. It is important to note that if the ultrasound is performed via the transabdominal approach, a different CPT code should be used (such as 76856). Additionally, if the ultrasound is a limited study focusing on one or more specific organs, CPT code 76857 should be used.

6. Documentation requirements

To support a claim for CPT 76830, the healthcare provider must document the following information:

• Reason for performing the transvaginal ultrasound
• Date and time of the procedure
• Specific reproductive organs assessed during the procedure
• Findings or abnormalities observed during the ultrasound
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 76830, ensure that the procedure was performed specifically as a transvaginal ultrasound for non-obstetrical purposes. It is important to follow payer guidelines and any applicable modifiers when reporting this code. For example, if only the physician’s interpretation is being reported, the professional component modifier 26 should be appended to the radiology code. If only the technical component is being reported, modifier TC should be appended. However, it is important to note that payer policies may exempt hospitals from appending modifier TC.

8. Historical information

CPT 76830 was added to the Current Procedural Terminology system on January 1, 1990, under the code name ‘Echography, transvaginal.’ On January 1, 2002, the code was changed to its current description, ‘Ultrasound, transvaginal.’

9. Examples

1. A healthcare provider performs a transvaginal ultrasound to assess the condition of a patient’s uterus and ovaries due to reported pelvic pain.
2. During a routine gynecological examination, a provider uses a transvaginal ultrasound to evaluate the patient’s fallopian tubes for any abnormalities.
3. A patient with a history of endometriosis undergoes a transvaginal ultrasound to monitor the progression of the condition and assess any potential complications.
4. A healthcare provider performs a transvaginal ultrasound to evaluate the size and position of a patient’s fibroid tumors.
5. During a fertility evaluation, a provider uses a transvaginal ultrasound to assess the patient’s ovaries and determine the presence of any potential fertility issues.
6. A patient with suspected pelvic inflammatory disease undergoes a transvaginal ultrasound to assess the condition of the reproductive organs and confirm the diagnosis.
7. A healthcare provider performs a transvaginal ultrasound to evaluate the thickness of the patient’s endometrial lining.
8. During a prenatal check-up, a provider uses a transvaginal ultrasound to assess the cervix length and monitor for any signs of preterm labor.
9. A patient with a history of ovarian cysts undergoes a transvaginal ultrasound to monitor the size and progression of the cysts.
10. A healthcare provider performs a transvaginal ultrasound to assess the condition of a patient’s cervix and evaluate any potential abnormalities.