2025 CPT code 76815
Effective Date: N/A Revision Date: N/A Radiology - Diagnostic Ultrasound Feed
Limited ultrasound examination of the pregnant uterus to assess specific aspects of the pregnancy, such as fetal heartbeat, placental location, fetal position, and/or qualitative amniotic fluid volume.
Modifiers such as 26 (professional component) and TC (technical component) can be applied when appropriate. Modifier 59 may be necessary if performed along with other procedures during the same encounter to indicate it was a distinct service.
Medical necessity is established by the specific clinical question that requires assessment, such as vaginal bleeding, abdominal pain, or the need to check fetal presentation. A limited exam to assess fetal position in the third trimester for delivery planning can be medically necessary, while performing this study at an earlier gestational age may not be covered if the clinical presentation does not clearly indicate a need for immediate determination of fetal presentation.
The physician or sonographer performs the ultrasound, applying gel to the patient's abdomen and using a transducer to obtain images. The physician interprets the images to assess the specified elements of the pregnancy.
In simple words: This is a limited ultrasound during pregnancy to check specific things like the baby's heartbeat, where the placenta is, the baby's position, and how much fluid is around the baby. It's not a full anatomy scan.
Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses. This limited examination focuses on one or more of the following elements: fetal heartbeat, placental location, fetal position, and qualitative amniotic fluid volume.
Example 1: A pregnant woman presents to the emergency department with abdominal pain. A limited ultrasound is performed to quickly assess fetal heartbeat and viability., A pregnant woman with a history of low amniotic fluid has a follow-up ultrasound to evaluate the amniotic fluid levels., A pregnant woman near term has an ultrasound to determine the fetal position (breech or vertex).
Documentation should include the reason for the limited exam, the elements visualized, and the findings related to those elements (e.g., fetal heartbeat present, placenta located in the anterior fundus, fetus in breech presentation, amniotic fluid volume appears normal).
- Specialties:Obstetrics and Gynecology, Radiology, Maternal-Fetal Medicine
- Place of Service:Office, Outpatient Hospital, Inpatient Hospital, Emergency Room - Hospital, Birthing Center