Summary & Overview
CPT 76802: Transabdominal Ultrasound for Additional Gestational Sac
CPT code 76802 identifies an add-on transabdominal obstetric ultrasound performed in the first trimester to image each additional gestational sac. As an add-on code, 76802 is billed in conjunction with a primary obstetric ultrasound when a multiple gestation requires separate imaging of extra sacs. Nationally, this code matters because multiple gestation pregnancies are associated with distinct clinical management needs and resource utilization, and billing clarity supports consistent coverage and reimbursement for technically necessary additional imaging.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of clinical context, typical sites of service, and how 76802 functions as an add-on to the primary first-trimester transabdominal ultrasound. The publication summarizes common billing and coding themes, applicable modifiers and service-line implications, and benchmarking considerations where available. It also highlights documentation elements commonly required to support medical necessity for additional sac imaging.
This overview is intended for coding professionals, billing managers, and clinicians to clarify the purpose of CPT code 76802, how it integrates with first-trimester obstetric imaging, and what sections of a billing review or policy update to examine when multiple gestation ultrasound services are billed.
Billing Code Overview
CPT code 76802 is an add-on transabdominal obstetric ultrasound procedure performed during the first trimester to image each additional gestational sac beyond the primary sac. This add-on service supplements the initial obstetric ultrasound and is used when multiple gestational sacs are present in a first-trimester examination.
Service type: Transabdominal obstetric ultrasound, add-on for additional gestational sac
Typical site of service: Outpatient imaging suite or ambulatory clinic setting where first-trimester obstetric ultrasounds are performed
Clinical & Coding Specifications
Clinical Context
A 28-year-old pregnant patient in the first trimester presents for evaluation after a transabdominal ultrasound identified a gestational sac. The initial exam documents one viable intrauterine pregnancy. During the same encounter the sonographer identifies a second separate gestational sac. The provider performs an additional targeted transabdominal ultrasound to image the second gestational sac, measure crown–rump length if possible, assess yolk sac and cardiac activity, and document placental location and intervening membranes. Images and measurements are added to the permanent record and interpreted by the performing clinician. Typical workflow: patient check-in and pregnancy history, transabdominal ultrasound for the initial sac (primary service), discovery of an additional sac, performance of the add-on procedure to examine each additional gestational sac, documentation of findings, and final interpretation and report delivery to the referring clinician.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
59 | Distinct Procedural Service | When this ultrasound add-on is distinct from another procedure performed at the same encounter and needs separate identification. |
76 | Repeat Procedure by Same Provider |