Clinical review: Sina Haeri, MD, MHSA (MFM) · Coder review pending · Drafted July 2026
76812Ultrasound
CPT 76812
CPT 76812: Detailed Anatomy Ultrasound, Each Additional FetusDetailed Anatomy Ultrasound, Each Additional Fetus
The short answer
Use 76812 once for each fetus beyond the first on a detailed fetal anatomic ultrasound. It is the add-on to 76811 and cannot be billed alone. High-risk twins are 76811 plus one unit of 76812, with the full detailed survey documented for each fetus.
Report 76812 when the detailed high-risk survey covers a multiple gestation and the extended anatomic element set is completed and documented for every fetus. Multiple gestation is itself a common indication for the detailed exam, so this pairing comes up often in MFM practices. The same payer restrictions that follow 76811, MFM involvement or AIUM accreditation where required, apply to the add-on, since it rides on the primary code's claim.
Documentation checklist
The detailed survey's longer element list applies to every fetus billed. Auditors expect per-fetus detail matching what a standalone 76811 report would show.
✓Detailed anatomic survey documented separately for each additional fetus
✓Biometry and growth parameters recorded per fetus
✓Chorionicity and amnionicity established and stated
✓High-risk indication for the detailed study on file
✓Amniotic fluid assessed per sac
✓Non-visualized structures listed with the reason
✓Images stored per fetus, signed interpretation covering all fetuses
✓Performed or supervised by a qualified MFM or trained sonologist
Global package rules
76812 is billed outside the global obstetric package, separate from 59400, and attaches only to 76811. Like the primary code, it is typically payable once per pregnancy per fetus; repeat detailed studies need a new documented indication. NCCI
TC-26 components
Mirror the component split used on 76811. Practices without their own accredited imaging service often bill only the professional component as an overread, in which case both the primary and the add-on go out with modifier 26.
76812
Global: one entity owns equipment and interpretation
76812-26
Professional: interpretation only
76812-TC
Technical: equipment and technologist
Reimbursement
2026 · national Medicare averages
Component
Work RVU
Total RVU
2026 rate
76812Global
1.74
5.82
$194.39
76812-26Professional
1.74
2.56
$85.51
76812-TCTechnical
0.00
3.26
$108.89
National amounts under the 2026 Medicare Physician Fee Schedule (non-facility total RVU x $33.4009 conversion factor, no locality/MAC adjustment). Commercial and Medicaid rates differ. Verify current values with your MAC before billing.
Common denials
CO-B15Add-on billed without 76811
Why it happens
76812 appeared without its primary code, or the 76811 line denied for credentialing or necessity and pulled the add-on down with it.
How to fix
Bill 76812 only with 76811 from the same session. If the primary denied, resolve that denial; the add-on cannot be salvaged independently.
Source: NCCI
N290Rendering provider not credentialed for the detailed study
Why it happens
The payer restricts the 76811 family to MFM specialists or AIUM-accredited practices and the rendering provider did not qualify.
How to fix
Confirm the payer's credentialing policy. Options are enrollment of a qualifying interpreter, referral to an accredited site, or a contracted professional-component overread.
Source: CMS
CO-50Multiple gestation or high-risk indication not supported
Why it happens
The diagnosis codes did not establish both the multiple gestation and the indication for a detailed survey.
How to fix
Add the multiple-gestation ICD-10 codes and the high-risk indication, then resubmit with corrected diagnosis pointers.
Source: ACOG/SMFM
CO-151Frequency exceeded
Why it happens
A repeat detailed study for the same fetus was billed without a new indication.
How to fix
The 76811 family is generally once per pregnancy per fetus. Document the new finding that warranted the repeat, or bill follow-up imaging as 76816.
Source: CMS
FAQ
What is the CPT code description for 76812?
In plain language, 76812 covers the detailed fetal anatomic ultrasound evaluation of each additional fetus in a multiple pregnancy. The first fetus is billed with 76811 and each extra fetus adds one unit of 76812.
Can 76812 be billed on its own?
No. It is an add-on code that only pays alongside 76811 from the same session.
Do the MFM and accreditation restrictions on 76811 apply to 76812?
Effectively yes. The add-on rides on the primary code, so any payer restriction that blocks 76811, such as an MFM-only or AIUM-accreditation policy, blocks 76812 with it.
How do I bill a detailed scan for high-risk triplets?
76811 for the first fetus and two units of 76812, with the full detailed survey documented for each of the three fetuses.
What is the difference between 76810 and 76812?
76810 is the additional-fetus add-on for the standard anatomy scan 76805. 76812 is the additional-fetus add-on for the detailed high-risk scan 76811. Match the add-on to the primary study performed.
Is 76812 inside the global OB package?
No. Obstetric ultrasounds are billed separately from the global package and 59400.
CPT® is a registered trademark of the American Medical Association. Educational reference only, not billing, legal, or medical advice.
Maintained by Ouma Health, a maternal-fetal telemedicine practice. Printed from obcodingguide.com, content current as of July 2026.