Summary & Overview
CPT 76945: Ultrasound Guidance and Imaging for Chorionic Villus Sampling
CPT code 76945 represents imaging supervision and interpretation provided during chorionic villus sampling (CVS), a prenatal diagnostic procedure that obtains placental tissue for genetic testing. Nationally, this code signals the professional ultrasound guidance component distinct from the separate invasive sampling procedure and is relevant to billing workflows for maternal-fetal medicine, radiology, and obstetrics providers. Proper use of 76945 affects coding accuracy, claims adjudication, and clinical documentation for prenatal diagnostic services.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise description of the clinical context for 76945, common service settings, and an overview of payer coverage considerations. The publication summarizes how 76945 is reported alongside the separately billed CVS sampling procedure, typical sites of service, and patterns relevant to professional imaging claims. It also highlights where input data is available and where input data is missing.
This piece serves clinicians, coders, and administrators seeking a clear, national-level briefing on the coding and billing role of CPT code 76945 in prenatal diagnostic care, including benchmarking and policy-relevant implications for reporting the imaging supervision and interpretation component of CVS.
Billing Code Overview
CPT code 76945 describes imaging supervision and interpretation provided during a chorionic villus sampling procedure, in which chorionic villi (placental tissue) are sampled under ultrasound guidance. The service involves real-time ultrasound imaging to locate the placenta and guide the sampling instrument for the separately reportable invasive procedure.
Service type: Ultrasound guidance and imaging supervision/interpretation.
Typical site of service: Outpatient hospital setting, ambulatory surgery center, or specialized maternal-fetal medicine clinic where invasive prenatal diagnostic procedures are performed.
Clinical & Coding Specifications
Clinical Context
A 34-year-old pregnant patient at 10 weeks' gestation is referred for chorionic villus sampling (CVS) after a positive first-trimester screening indicating increased risk for a chromosomal abnormality. The maternal-fetal medicine specialist schedules the CVS in an outpatient ambulatory surgery or procedure suite. Before the procedure, the patient undergoes pre-procedure counseling and informed consent. On the day of service, an ultrasound is used to locate the placenta and guide transabdominal or transcervical sampling of chorionic villi. The supervising physician performs real-time imaging supervision and interprets the ultrasound to ensure needle trajectory avoids fetal parts and major maternal vessels; images are documented and saved. The proceduralist separately reports the tissue sampling service; 76945 is reported by the imaging physician for supervision and interpretation of the ultrasound guidance for the separately reportable CVS sampling. Typical billing includes facility and professional components as applicable, with potential application of modifiers for reduced services, multiple physicians, or technical/professional splits. Typical sites of service are outpatient ambulatory surgery centers, hospital outpatient departments, or specialized maternal-fetal medicine clinics equipped for invasive prenatal procedures.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component |