Summary & Overview
CPT 76810: Transabdominal Ultrasound for Additional Gestation/Fetus
CPT code 76810 denotes an add-on transabdominal ultrasound performed to evaluate each additional gestation sac or fetus after the first trimester. This code is clinically important for managing multiple gestations, informing prenatal care plans, and documenting the need for separate imaging of each additional fetus. Nationally, accurate use of CPT code 76810 affects clinical records, utilization tracking, and claims adjudication for obstetric imaging services.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the code’s clinical role, typical sites where the service is delivered, and the common payer landscape relevant to reimbursement and coverage. The publication reviews billing and coding context, common modifiers used with this service, and operational considerations for documenting add-on fetal imaging.
This analysis provides benchmarks for expected use, highlights policy or coverage considerations that commonly affect obstetric ultrasound coding nationally, and outlines the clinical context for when CPT code 76810 is appropriate. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 76810 is an add-on transabdominal ultrasound performed to examine each additional gestation sac or fetus after the first trimester. The procedure is used when multiple gestations require individual assessment beyond the initial fetal evaluation.
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Service type: Obstetric imaging, ultrasound add-on for additional fetus/gestation sac
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Typical site of service: Outpatient radiology or obstetrics clinic settings where transabdominal ultrasound exams are performed
Clinical & Coding Specifications
Clinical Context
A 32-year-old pregnant patient with a confirmed multiple gestation pregnancy (for example, twins) presents for a second‑trimester anatomic survey. The provider performs a standard transabdominal fetal ultrasound to evaluate the first fetus and then performs additional transabdominal ultrasound examinations for each additional gestation after the first trimester. Typical workflow: patient registration and verification of prenatal records, targeted history and indication documented (multiple gestation), obtain informed consent for ultrasound imaging, perform transabdominal sonographic survey of fetal anatomy, biometry, placental location, amniotic fluid assessment and fetal number. Each additional fetus beyond the first is examined and documented, with images and measurements stored in the medical record. Imaging interpretation and a formal report are completed and the professional and technical components are documented as appropriate for billing and claim submission. Typical site of service: outpatient obstetric clinic, hospital-based maternal‑fetal medicine unit, or ambulatory imaging center. Service type: transabdominal diagnostic ultrasound add‑on for each additional gestation sac or fetus after the first trimester.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the physician's interpretation/report component. |
TC | Technical component | Use when billing only equipment, technician, and technical resources. |
59 | Distinct procedural service | Use when procedures that are normally bundled are separate and distinct (use with caution and supporting documentation). |
76 | Repeat procedure by same physician | Use when the same provider repeats the ultrasound on the same day. |
77 | Repeat procedure by another physician/qualified health professional | Use when a different provider repeats the procedure on the same day. |
52 | Reduced services | Use when the procedure is partially reduced or not completed as originally planned. |
53 | Discontinued procedure | Use when the procedure is started but terminated due to extenuating circumstances. |
22 | Unusual procedural services | Use when services are substantially greater than typically required; documentation must support increased work. |
50 | Bilateral procedure | Generally not applicable to fetal ultrasound; included if payer requires bilateral modifier for paired organ imaging (rare). |
59 | Distinct procedural service | Use when separate and distinct ultrasound services are performed and need to be reported separately. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207V00000X | Obstetrics & Gynecology | Most common specialty performing obstetric ultrasound. |
| 207VP0800X | Maternal & Fetal Medicine | Specialists who perform detailed fetal surveys in high‑risk pregnancies. |
| 207Q00000X | Radiology | Interprets diagnostic obstetric ultrasounds in some centers. |
| 174400000X | Diagnostic Medical Sonography (Obstetric & Gynecologic) | Sonographers who perform the technical component under supervision. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
| Data not available in the input. | Data not available in the input. | Data not available in the input. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester; single or first gestation | Performed as the primary ultrasound for the first fetus; 76810 is reported for each additional fetus after this service. |
76811 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester; transvaginal for fetal and maternal evaluation | May be used in conjunction when transvaginal imaging is required for additional anatomic detail, separate from 76810. |
76815 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, limited, after first trimester | Used for limited follow‑up examinations; not a substitute for full survey codes when multiple gestations require complete evaluation. |
76856 | Fetal biophysical profile with nonstress test (includes real-time ultrasound) | Often performed in multiple gestation pregnancies to assess fetal well‑being in addition to anatomic surveys. |
58300 | Insertion of intrauterine device (IUD) | Not directly related to obstetric ultrasound; Data not available in the input. |