Check for any abnormal biochemical markers.This ultrasound is performed if in addition to the indications under CPT code 76801 any of the following indications are suspected or need to be evaluated. CPT code 76811 is used for billing this ultrasound screening which is used for evaluation of the fetal brain, heart, abdominal organs, face or umbilical cord. In case of any suspected genetic abnormality, it may be necessary to perform an ultrasound during the second or third trimester of pregnancy. In order to use CPT 76801, it is important that all the following elements required for a complete study are covered – adnexa and maternal uterus examination assessment of shape of the gestational sac and amniotic fluid volume determine gestation sacs and fetus numbers measurement of fetus and placental anatomy/visible fetal survey. Evaluation if hydatidiform mole suspected.Check for uterine abnormalities or adnexal masses.Check for and evaluate ectopic pregnancy.Confirmation of intra-uterine pregnancy.For facilitating safety after embryo transfer, sampling for chorionic villus, or after intra-uterine device removal.The screening is conducted between the eight and fourteenth week of pregnancy and should be performed if indications include any of the following: 76818 – 76819 used for billing fetal biophysical profileĬPT code 76801 is used for billing maternal and fetal trans-abdominal ultrasound evaluation in the first trimester of pregnancy in the single or first gestation.76817 used for billing trans-vaginal ultrasound study.76816 used for billing follow-up trans-abdominal ultrasound study.
76815 used for billing limited trans-abdominal ultrasound study.76813 – 76814 used for billing fetal nuchal translucency measurement.76811 – 76812 used for billing the above and detailed fetal anatomical evaluation.76801 – 76810 used for billing maternal and fetal evaluation.The code ranges are based on the following scenarios: It is inappropriate to use the screening to determine fetal sex or to just provide a picture or view the fetus.įor medical billing purposes, ultrasound recordings are listed under the CPT codes ranging from 76801 to 76819. However, fetal ultrasound should only be performed if there is a medical indication that needs to be examined. Services performed from the 8 th week after gestation to around one and a half months post delivery is considered as a part of maternal-fetal medicine.Īn ultrasound can be recorded at any stage of the pregnancy. While both regular pregnancy and maternal-fetal screening tests are used to check on the health of the mother and the fetus during the course of the pregnancy and post delivery, there is a significant difference between the CPT codes used for billing the procedures and services performed. Depending on the advice of the doctor, procedures to check on the health of the fetus may include Doppler velocimetry, ultrasound, echocardiography, Doppler umbilical scan, Doppler cerebral artery scanning etc. Women planning to have a baby can start their medical check-ups pre conception and continue with regular check-ups right through the course of their pregnancy and after. From basic check-ups to advanced screenings, obstetrical procedures strive to ensure the safety and health of both the mother and the baby. Tremendous advances have been made in healthcare during pregnancy and child birth.
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