Summary & Overview
CPT 76513: Immersion B-Scan or High-Resolution Biomicroscopy of Anterior Segment
CPT code 76513 identifies immersion B–scan ultrasound or high-resolution biomicroscopy imaging of the anterior segment of one or both eyes. The code covers diagnostic imaging used to visualize anterior ocular structures when slit-lamp or standard imaging is insufficient. Nationally, this code matters for ophthalmology practices, imaging centers, and payers because it defines billing for specialized anterior segment imaging that can affect diagnostic pathways and downstream costs.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of how the code is described clinically, typical sites of service, and the service type. The publication summarizes payer coverage patterns and common modifier usage where available, outlines typical clinical indications for immersion B–scan and high-resolution biomicroscopy, and highlights billing considerations relevant to outpatient ophthalmic imaging. Data not available in the input is noted where applicable.
This content is intended to provide a concise national-level reference for coding, clinical context, and payer considerations related to CPT code 76513.
Billing Code Overview
CPT code 76513 describes the use of immersion B–scan ultrasound or high-resolution biomicroscopy imaging to examine the anterior segment of one or both eyes. This procedure captures detailed cross-sectional or high-magnification images of anterior ocular structures, supporting diagnosis and management of anterior segment pathology.
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Service type: Diagnostic ophthalmic ultrasound / high-resolution biomicroscopy imaging
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Typical site of service: Ambulatory ophthalmology or optometry clinic, hospital outpatient department, or other outpatient imaging facility
Clinical & Coding Specifications
Clinical Context
A 67-year-old patient presents to an ophthalmology clinic with progressive anterior segment symptoms including pain, photophobia, decreased vision, and suspicion for anterior segment pathology after prior cataract surgery. The provider performs an immersion B–scan ultrasound or high-resolution biomicroscopy to evaluate the anterior chamber, iris, ciliary body, intraocular lens position, anterior chamber depth, and to assess for masses, detachments, malpositioned lenses, or occult foreign bodies. The clinical workflow includes patient intake and history, topical anesthesia when required, positioning at the slit lamp or scan table, sterile immersion or coupling medium placement, acquisition of real-time anterior segment ultrasound or UBM images, interpretation by the ophthalmologist, and documentation of findings and measurement data in the medical record. Imaging results guide immediate management decisions such as medical therapy adjustments, referral for surgical intervention, or monitoring.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when only the interpreting physician bills for the professional interpretation of the imaging study separate from technical imaging services. |
TC |