Summary & Overview
CPT 76512: B-scan Ophthalmic Ultrasound of Eye and Orbit
CPT code 76512 designates B-scan ophthalmic ultrasound imaging, optionally with a non-qualitative A-scan overlay, to visualize intraocular and orbital structures. This imaging modality is important nationally for diagnosing retinal detachments, intraocular masses, vitreous hemorrhage, and orbital pathology when direct visualization is limited. It supports clinical decision-making in ophthalmology and often informs surgical planning.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will find a concise synthesis of coverage and utilization patterns across major payers, common billing considerations, and clinical context for when B-scan imaging is indicated. The publication summarizes typical sites of service and the role of 76512 within ophthalmic diagnostic workflows.
The analysis presents benchmarks and payment context, highlights recent policy updates affecting imaging authorization and documentation expectations, and explains clinical scenarios that commonly prompt a B-scan. Where input data is missing, the report notes that information is not available. The content is intended for a national audience of billing managers, policy analysts, and clinical leaders who oversee ophthalmic imaging services.
Billing Code Overview
CPT code 76512 describes B-scan ultrasound imaging of the eye and orbit, with or without a non-qualitative A-scan superimposed, used to examine intraocular and orbital structures. This diagnostic imaging procedure captures cross-sectional views of the globe and surrounding tissues to evaluate lesions, retinal detachments, vitreous opacities, intraocular foreign bodies, and orbital pathology.
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Service type: Diagnostic ophthalmic ultrasound (B-scan), sometimes combined with non-qualitative A-scan
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Typical site of service: Eye clinic, ophthalmology office, outpatient imaging center, or hospital outpatient department
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Clinical & Coding Specifications
Clinical Context
A 62-year-old patient presents to an ophthalmology clinic with progressive visual disturbance and a history of dense media opacity in the affected eye. The ophthalmologist orders a diagnostic ocular ultrasound using B-scan technique to evaluate intraocular and orbital structures because direct ophthalmoscopic visualization is limited. The procedure is performed in the outpatient ophthalmology clinic suite by a credentialed ophthalmologist or ocular ultrasonographer under the provider's supervision. The clinical workflow includes patient history and consent, external ocular exam, topical anesthesia if needed, placement of a coupling gel and probe on the closed eyelid (or in the fornix if indicated), acquisition of 2-D B-scan images through multiple meridians with or without a non-qualitative A-scan superimposed, immediate image interpretation by the provider, documentation of findings (for example, retinal detachment, vitreous hemorrhage, intraocular mass, lens dislocation, or orbital lesion), coding as 76512, and communication of results to the patient with appropriate follow-up or referral.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the interpreting physician's professional component separate from the technical facility component. |