Summary & Overview
CPT 76886: Ultrasound of the Hip, Infant
CPT code 76886 represents a diagnostic ultrasound of the hip, a noninvasive B‑mode examination that acquires longitudinal, transverse and oblique two‑dimensional images to evaluate infant hips. Nationally, this code is used in pediatric and neonatal imaging to assess hip development and detect conditions such as dysplasia, making it an important tool for early diagnosis and follow-up.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare and Medicare. Readers will find a concise overview of clinical context for the procedure, typical sites of service, common payer coverage patterns, and operational benchmarks related to utilization and coding practice. The publication summarizes coding definitions, common modifiers used with this service, and payer considerations that affect claims processing and reimbursement workflows. It also highlights areas where clinical documentation and imaging technique are commonly scrutinized by payers.
This summary is intended for billing managers, radiology administrators, and policy analysts seeking a national-level briefing on CPT code 76886, including practical implications for coding consistency and payer engagement.
Billing Code Overview
CPT code 76886 describes an ultrasound of the hip, a noninvasive imaging procedure that uses high-frequency sound waves to produce real-time, two-dimensional images of an infant's hip. The exam is performed with a standard B-mode ultrasonic imager and includes longitudinal, transverse, and oblique imaging of the hip region.
Service type: Diagnostic ultrasound imaging
Typical site of service: Outpatient imaging center or hospital radiology department, frequently performed in pediatric or neonatal imaging settings, and may also be performed in ambulatory clinics with appropriate ultrasound capability.
Clinical & Coding Specifications
Clinical Context
An infant (typically 4–12 weeks old) is referred to radiology for a diagnostic hip ultrasound due to a positive Ortolani/Barlow exam, asymmetric thigh creases, leg length discrepancy, or a family history of developmental dysplasia of the hip (DDH). The ultrasound is performed by a sonographer with an interpreting pediatric radiologist or pediatric orthopedic surgeon documenting the study. The exam uses a standard B‑mode transducer to obtain longitudinal, transverse, and oblique images of each hip in coronal and transverse planes while the infant is in a neutral and flexed position. The clinical workflow includes verifying patient identity and indication, obtaining consent from the parent or guardian, performing bilateral hip imaging, acquiring dynamic images if instability is suspected, sending images to the PACS, and finalizing a report that describes alpha and beta angles, acetabular morphology, femoral head coverage, and any subluxation or dislocation. Results guide management decisions such as observation, orthotic brace (Pavlik harness) application, or referral to pediatric orthopedics for further intervention.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the interpreting physician's service separate from technical imaging. |
TC | Technical component | Use when reporting only the equipment, technician, and technical portion of the study. |
RT | Right side | Use when specifically indicating the right hip when payer requires laterality. |
LT | Left side | Use when specifically indicating the left hip when payer requires laterality. |
59 | Distinct procedural service | Use when an ultrasound is performed separately from another distinct service on the same day. |
76 | Repeat procedure by same physician | Use when the same provider repeats the ultrasound on the same day. |
77 | Repeat procedure by another physician | Use when a different provider repeats the ultrasound on the same day. |
52 | Reduced services | Use when the study is limited or incomplete and a reduced service is reported. |
53 | Discontinued procedure | Use when the ultrasound was started but discontinued for medical reasons. |
22 | Increased procedural service | Use when additional work or time significantly exceeds the typical service (rare for routine hip ultrasound). |
76 | Repeat procedure by same physician | Use when reimaging is required later the same day by the same provider. |
78 | Return to OR for related procedure | Not commonly used for diagnostic hip ultrasound; applicable if ultrasound guidance is used intraoperatively. |
QX | Service performed by non-physician practitioner with assistant | Use when applicable under payer policy for CRNA/assistant attributing technical or professional component. |
QY | Medical direction of two, three, or four concurrent anesthesia procedures | Not typically applicable to ultrasound; include only when anesthesia direction is reported in the encounter. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207RH0000X | Pediatric Radiology | Interpreting physicians commonly board-certified in pediatric radiology. |
| 2080P0207X | Diagnostic Radiology | General diagnostic radiologists frequently perform and interpret infant hip ultrasounds. |
| 2086S0122X | Orthopedic Surgery | Pediatric orthopedic surgeons may perform or request and interpret studies for DDH management. |
| 207L00000X | Family Medicine | Family physicians in outpatient settings may order and sometimes perform point-of-care ultrasound. |
| 363LP0808X | Ultrasound Diagnostic Medical Sonographer | Sonographers perform the scanning and image acquisition under physician 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 |
|---|---|---|
76881 | Ultrasound, newborn, limited (e.g., single structure, follow-up) | Used when a limited hip ultrasound is performed for focused follow-up of a previously identified abnormality. |
93971 | Duplex scan of extremity veins, non-invasive, complete bilateral study (screening) | Not routinely used with hip ultrasound but may be ordered in differential cases involving limb vascular issues; included here as less commonly associated. |
76000 | Fluoroscopic guidance for needle placement (e.g., arthrography) | May be used when guidance is needed for procedures related to hip management; less commonly paired with diagnostic ultrasound. |
19318 | Reduction of hip dislocation (open or closed) — note: surgical codes vary | Surgical management codes may follow diagnostic evaluation when dislocation is confirmed; included to indicate possible downstream interventions. |
99456 | Work-related and medical employer services billing and consultation | Administrative or consultative services occasionally billed in context of occupational or medicolegal cases involving infants transported or seen in specialized settings. |