Remove confusion about 76811 cpt code

Basic OB codes with 76811 cpt code

Pregnancy CPT Codes are difficult to code in medical coding. Before we learn about 76811 CPT code, we first will check out few pregnancy radiology CPT codes. The CPT codes are divided on the number of weeks of pregnancy. The cpt codes used are for less than 14 weeks (76801) and more than 14 weeks of pregnancy (76805). In addition, the pregnancy cpt codes are divided as complete and limited exam. The CPT code for limited pregnancy exam is coded as 78615. In addition, we have CPT codes for additional gestation as add-on code for CPT 78601 and 76805. The additional add-on cpt code for 76801 is 76802 and for 76805 is 76810.
Remove confusion about 76811 cpt code

Read also : when to use Pregnancy normal and incidental ICD 10 codes



The detail description of Pregnancy CPT Codes is explained below:


Procedure Description
CPT code
Ultrasound less than 14 weeks
76801
Ultrasound less than 14 weeks: additional gestation
+76802
Ultrasound more than 14 weeks
76805
Ultrasound more than 14 weeks: additional gestation
+76810
Ultrasound detailed exam of maternal and fetal evaluation
76811
Ultrasound detailed exam of maternal and fetal evaluation: additional gestation
+76812
Limited Ultrasound: one or more gestation
76815
Follow-up Ultrasound  (re-evaluation of fetal size, organ system or previous abnormality seen on other scan)
76816
Ultrasound: Transvaginal
76817
Fetal Biophysical profile with non-stress testing
76818
Fetal Biophysical profile without non-stress testing
76819

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When to code 76811 cpt code

All of the above CPT codes are code for OB or Pregnancy reports. The OB or Pregnancy CPT codes are coded as per the documentation. The Pregnancy codes are codes limited or complete depending on the documentation. Out of these CPT codes, we will learn about the 76811 CPT code. OB chart with detailed exam of maternal and fetal evaluation are coded with 76811 CPT code. However, many of the medical coders are having difficulty when to use 76811 CPT code. The other CPT code 76801 or 76805 is coded sometimes because coders do not to know what are the measures required to code 76811 CPT code. Therefore, here is the full list of the measure to check 76811 CPT code.

78611 cpt code Includes:
Determination of the number of gestational/chorionic sacs and fetuses
Evaluation of:
Abdominal organ specific anatomy
Amniotic fluid
Chest anatomy
Face
Fetal brain/ventricles
Four chambered heart
Heart/outflow tracts and chest anatomy
Intracranial, spinal, abdominal anatomy
Limbs including number, length, and architecture
Other fetal anatomy as indicated
Placenta location
Umbilical cord insertion site
Examination of maternal adnexa if visible
Gestational sac/fetal measurement appropriate for gestational age (older than or equal to 14 weeks 0 days)
Written documentation of each component of exam, including reason for nonvisualization, when applicable

After, checking presence of all the above measure we can go ahead and code 76811 CPT code. Any of the measure missing will lead to code OB limited CPT code 76815.

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