ICD-10-PCS Code For Second Trimester, Multiple Gestation: Procedure Code Group Overview

The International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS) code group BY4D includes procedures performed to capture and display real-time ultrasound images and flow information of the fetus and obstetrical structures in the second trimester multiple gestation. These ICD-10-PCS codes are used for inpatient documentation when ultrasonography is performed to assess fetal anatomy, growth, viability, or placental and cord status in a multiple gestation pregnancy during the second trimester. Accurate coding within the ICD-10-PCS BY4D group is essential for proper inpatient reimbursement, as it captures the specific imaging performed and supports clinical documentation accuracy.

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Second Trimester, Multiple Gestation Ultrasonography Procedure Overview

This code group includes real-time ultrasonography procedures performed on pregnancies with multiple gestation during the second trimester and targets the fetus and obstetrical body system. These procedures capture reflected and attenuated high-frequency sound waves to develop images or flow information used for fetal assessment and monitoring. Accurate ICD-10-PCS coding of these procedures supports correct inpatient documentation and appropriate reimbursement for obstetrical imaging services.

Code Attributes

Character	ICD-10-PCS Category	Code Group Details
B	Section	Imaging
Y	Body System	Fetus and Obstetrical
4	Operation	Ultrasonography
D	Body Part	Second Trimester, Multiple Gestation

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ICD-10-PCS Code For Second Trimester, Multiple Gestation: Procedure Code Group Overview

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Second Trimester, Multiple Gestation Ultrasonography Procedure Overview

Code Attributes

Character	ICD-10-PCS Category	Code Group Details
B	Section	Imaging
Y	Body System	Fetus and Obstetrical
4	Operation	Ultrasonography
D	Body Part	Second Trimester, Multiple Gestation

When to Use

Use a code from this group when ultrasonography is performed during the second trimester to evaluate multiple gestation fetuses, including assessments of anatomy, growth, placental position, or fetal well-being. These codes apply when real-time imaging or flow assessment is documented as performed for inpatient obstetrical care.

ICD-10-PCS Codes

1 rows

ICD-10-PCS Code	Description
BY4DZZZ	Ultrasonography of Second Trimester, Multiple Gestation

Typical Clinical Scenarios

A pregnant patient at 20 weeks gestation with a known dichorionic diamniotic twin pregnancy is admitted for inpatient maternal monitoring due to new-onset antepartum bleeding and evaluation for preterm labor; clinicians need real-time assessment of fetal anatomy, growth, fetal heart activity, and placental locations for both fetuses to guide immediate management, so a second-trimester multiple-gestation ultrasonography is performed. Typical codes: BY4DZZZ
A scheduled inpatient fetal medicine consultation at 22 weeks for a patient with multiple gestation identified on routine prenatal care to perform detailed anatomic survey and Doppler flow assessment because one twin demonstrated growth restriction on outpatient screening; the procedure documents real-time imaging of both fetuses and umbilical-placental circulation to plan ongoing inpatient surveillance. Typical codes: BY4DZZZ
A patient with a multiple gestation at 24 weeks is admitted emergently for decreased fetal movements and abnormal nonstress testing; immediate inpatient ultrasonography of the second trimester multiple pregnancy is used to assess fetal viability, biophysical profiles, and real-time flow to determine need for urgent intervention. Typical codes: BY4DZZZ

ICD-10-PCS Code For Fetal Umbilical Cord: Procedure Code Group Overview

BY48-PLACENTA-ULTRASONOGRAPHY

ICD-10-PCS Code For Placenta: Procedure Code Group Overview

BY49-FIRST-TRIMESTER-SINGLE-FETUS-ULTRASONOGRAPHY

ICD-10-PCS Code For First Trimester Single Fetus: Procedure Code Group Overview

BY4B-FIRST-TRIMESTER-MULTIPLE-GESTATION-ULTRASONOGRAPHY

ICD-10-PCS Code For First Trimester, Multiple Gestation: Procedure Code Group Overview

BY4C-SECOND-TRIMESTER-ULTRASONOGRAPHY

ICD-10-PCS Code For Second Trimester, Single Fetus: Procedure Code Group Overview

BY4F-THIRD-TRIMESTER-SINGLE-FETUS-ULTRASONOGRAPHY

ICD-10-PCS Code For Third Trimester Single Fetus: Procedure Code Group Overview

BY4G-THIRD-TRIMESTER-MULTIPLE-GESTATION-ULTRASONOGRAPHY

ICD-10-PCS Code For Third Trimester, Multiple Gestation: Procedure Code Group Overview

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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When to Use

ICD-10-PCS Codes

1 rows

ICD-10-PCS Code	Description
BY4DZZZ	Ultrasonography of Second Trimester, Multiple Gestation

Typical Clinical Scenarios

A pregnant patient at 20 weeks gestation with a known dichorionic diamniotic twin pregnancy is admitted for inpatient maternal monitoring due to new-onset antepartum bleeding and evaluation for preterm labor; clinicians need real-time assessment of fetal anatomy, growth, fetal heart activity, and placental locations for both fetuses to guide immediate management, so a second-trimester multiple-gestation ultrasonography is performed. Typical codes: BY4DZZZ
A scheduled inpatient fetal medicine consultation at 22 weeks for a patient with multiple gestation identified on routine prenatal care to perform detailed anatomic survey and Doppler flow assessment because one twin demonstrated growth restriction on outpatient screening; the procedure documents real-time imaging of both fetuses and umbilical-placental circulation to plan ongoing inpatient surveillance. Typical codes: BY4DZZZ
A patient with a multiple gestation at 24 weeks is admitted emergently for decreased fetal movements and abnormal nonstress testing; immediate inpatient ultrasonography of the second trimester multiple pregnancy is used to assess fetal viability, biophysical profiles, and real-time flow to determine need for urgent intervention. Typical codes: BY4DZZZ

ICD-10-PCS Code For Fetal Umbilical Cord: Procedure Code Group Overview

BY48-PLACENTA-ULTRASONOGRAPHY

ICD-10-PCS Code For Placenta: Procedure Code Group Overview

BY49-FIRST-TRIMESTER-SINGLE-FETUS-ULTRASONOGRAPHY

ICD-10-PCS Code For First Trimester Single Fetus: Procedure Code Group Overview

BY4B-FIRST-TRIMESTER-MULTIPLE-GESTATION-ULTRASONOGRAPHY

ICD-10-PCS Code For First Trimester, Multiple Gestation: Procedure Code Group Overview

BY4C-SECOND-TRIMESTER-ULTRASONOGRAPHY

ICD-10-PCS Code For Second Trimester, Single Fetus: Procedure Code Group Overview

BY4F-THIRD-TRIMESTER-SINGLE-FETUS-ULTRASONOGRAPHY

ICD-10-PCS Code For Third Trimester Single Fetus: Procedure Code Group Overview

BY4G-THIRD-TRIMESTER-MULTIPLE-GESTATION-ULTRASONOGRAPHY

ICD-10-PCS Code For Third Trimester, Multiple Gestation: Procedure Code Group Overview

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

ICD-10-PCS Code For Second Trimester, Multiple Gestation: Procedure Code Group Overview

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Second Trimester, Multiple Gestation Ultrasonography Procedure Overview

Code Attributes

OpenPayer

ICD-10-PCS Code For Second Trimester, Multiple Gestation: Procedure Code Group Overview

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Second Trimester, Multiple Gestation Ultrasonography Procedure Overview

Code Attributes

When to Use

ICD-10-PCS Codes

Typical Clinical Scenarios

Related Codes

References

When to Use

ICD-10-PCS Codes

Typical Clinical Scenarios

Related Codes

References

ICD-10-PCS Code For Second Trimester, Multiple Gestation: Procedure Code Group Overview

Sign up for ICD-10-PCS Code For Second Trimester, Multiple Gestation: Procedure Code Group Overview policy alerts

Second Trimester, Multiple Gestation Ultrasonography Procedure Overview

Code Attributes

ICD-10-PCS Code For Second Trimester, Multiple Gestation: Procedure Code Group Overview

Sign up for ICD-10-PCS Code For Second Trimester, Multiple Gestation: Procedure Code Group Overview policy alerts

Second Trimester, Multiple Gestation Ultrasonography Procedure Overview

Code Attributes

When to Use

ICD-10-PCS Codes

Typical Clinical Scenarios

Related Codes

What procedures are included in the BY4D code group?

Which ICD-10-PCS code represents ultrasonography of second trimester multiple gestation?

In what clinical context is `BY4DZZZ` used for inpatient documentation?

What are the coded attributes for the BY4D procedure group?

Why is accurate coding within the BY4D group important?

References

When to Use

ICD-10-PCS Codes

Typical Clinical Scenarios

Related Codes

What procedures are included in the BY4D code group?

Which ICD-10-PCS code represents ultrasonography of second trimester multiple gestation?

In what clinical context is `BY4DZZZ` used for inpatient documentation?

What are the coded attributes for the BY4D procedure group?

Why is accurate coding within the BY4D group important?

References