CPT 76815 is a limited ultrasound of a pregnant uterus. It is frequently used in OB/GYN triage to quickly check fetal well-being, but it is often confused with comprehensive scans.
Limited vs Complete Scans
Use 76815 when you are performing a quick, focused assessment for one or more specific reasons, such as:
- Checking fetal heartbeat.
- Evaluating amniotic fluid volume.
- Determining fetal position (presentation).
Do NOT use 76815 for a full anatomic survey (76805) or a complete first-trimester scan (76801).
Quantity Rules
76815 is billed once per session, regardless of how many fetuses are present. If a patient is pregnant with twins, you still only bill one unit of 76815.
NCCI Edits
If the patient returns later in the day for a worsening condition and a second limited ultrasound is medically necessary, Modifier 59/XE must be appended to the second scan.