CPT® Code 76830 – Diagnostic Ultrasound Procedures of the Non-Obstetric Pelvis – Coding by AAPC (2023)

FAQs

What is the CPT code for non OB pelvic ultrasound? ›

CPT code 76856 represents a non-obstetrical pelvic ultrasound, real time with image documentation; complete.

If the patient is NOT pregnant use the code (76830). It is important to note that there is only a complete exam code for transvaginal ultrasound. Many emergency department transvaginal ultrasounds are less than complete exams, thus it is appropriate to use the modifier -52 Reduced Services.

We have two CPT code for abdominal ultrasound, 76700 and 76705. The complete ultrasound of abdomen is codes 76700. The complete ultrasound of abdomen will include eight organs. The eight organs include gallbladder, common bile duct (CBD), liver, pancreas, spleen, inferior vena cava (IVC), aorta and two kidneys.

There are two CPT codes for coding Pelvic Ultrasound, procedure code 76856 and 76857. Now, when all the pelvic organs including the uterus, adnexal structures, ovaries, endometrium, bladder along with a pelvic diagnosis are present, you can go ahead and code CPT code 76856 (complete exam).

CPT code 76830 is also known as an endovaginal ultrasound for visualization of the endometrium, uterus, and other internal structures. If a translabial or transvaginal ultrasound is performed for external signs and symptoms use CPT code 76857, limited pelvis.

Non-Obstetric Ultrasound (NOUS) is a procedure that offers patients non-invasive scans to diagnose a range of conditions. NOUS scans are often available in local GP services. As there are a number of different providers of this service, patients are able to visit the service that suits them best.

The CPT manual defines ultrasounds as separate from E&M's, and coding edits clearly state that a modifier 25 is not needed on the E&M when billed with ultrasounds.

Code 76830 (ultrasound, transvaginal) should not be reported as part of the hysterosalpingogram. It may only be reported with 76831 if a diagnostic ultrasound is ordered, medically necessary, performed, and documented separately from the hysterosalpingogram.

Ultrasonography of Abdomen and Pelvis

ICD-10-PCS BW41ZZZ is a specific/billable code that can be used to indicate a procedure.

There are three types of pelvic ultrasound: abdominal, vaginal (for women), and rectal (for men). These exams are frequently used to evaluate the reproductive and urinary systems. Ultrasound is safe, noninvasive and does not use ionizing radiation. This procedure requires little to no special preparation.

What is the ICD 10 code for pelvic ultrasound? ›

76856 is a complete evaluation and must minimally include: Female: description and measurements of the uterus and adnexal structures, measurement of the endometrium and bladder, and a description of any pelvic pathology.

Now You Can Report Transvaginal and Abdominal Ultrasounds Performed During the Same Visit. Newly deleted edits in version 10.1 of the National Correct Coding Initiative (NCCI) make submitting 76830 and 76857 or 76856 acceptable when the ob-gyn performs both procedures during the same visit.

A transvaginal ultrasound is an imaging procedure that allows your provider to see your pelvic cavity and the organs inside your pelvis. These organs include your cervix, uterus, fallopian tubes and ovaries.

There are different types of pelvic ultrasounds. Each looks at different organs or serves a particular purpose: Abdominal ultrasound, which examines organs from outside the belly. Pregnancy ultrasound, which watches fetal development in the uterus.

During the test, a trained medical technician will squirt a small amount of warm gel on your skin over your pelvic area. The technician will move a handheld device (called a wand) through the gel and across your pelvis. The technician will monitor the images on a nearby screen and record the images for the doctor.

Code 76641 describes a complete examination of all four quadrants of the breast and the retroareolar region; 76642 describes a limited breast ultrasound (e.g., a focused examination limited to one or more elements of 76641, but not all four).

RE: CPT code 76816 vs 76815

If you are only checking the fluid volume, you would bill 76815. If you are also evaluating some of the fetal anatomy, you would bill 76816.

In the last paragraph of the Obstetrical guidelines (before the 76801 description) it states "Code 76817 describes a transvaginal obstetric ultrasound performed separately or in addition to one of the transabdominal examinations described above." 76815 is one of the exams listed "above", therefore 76815 is a ...

I was trained that if ultrasound of right and left kidney is done (with or w/out bladder), that CPT 76775 should be used; however, if above is done along with renal pelvis, ureters, bladder then the complete would be used (76770).

Is tomosynthesis the same as ultrasound? ›

Tomosynthesis provides better imaging quality and accuracy in detection and classification of the lesions [4]. Ultrasonography is used in conjugation with mammography in detection and assessment of breast lesions as it is an inexpensive, noninvasive and non-ionizing imaging modality.

There should not be two CPT codes billed if a bilateral ultrasound exam is needed.