Clinical review: Sina Haeri, MD, MHSA (MFM) · Coder review pending · Drafted July 2026
76814Ultrasound
CPT 76814
CPT 76814: Nuchal Translucency Ultrasound, Each Additional FetusNuchal Translucency Ultrasound, Each Additional Fetus
The short answer
Use 76814 once for each fetus beyond the first on a nuchal translucency ultrasound. It is an add-on to 76813 and cannot be billed alone. NT screening of twins is 76813 plus one unit of 76814, with a separate certified measurement documented for each fetus.
Source: NCCISource: CMS MPFS 2026Source: AIUM
When to use 76814
Report 76814 when NT screening covers a multiple gestation and a technically adequate NT measurement is obtained and documented for each fetus within the 11w0d to 13w6d window. The certification requirements that govern 76813, NTQR or FMF credentialing for the sonographer and interpreting physician, apply to every fetus measured. If a measurement could not be obtained for one fetus, do not bill the add-on for that fetus.
Documentation checklist
Each billed fetus needs its own defensible measurement. The add-on is not a per-pregnancy multiplier; it is paid per completed per-fetus study.
✓NT measurement recorded per fetus to a tenth of a millimeter
✓Midsagittal technique image stored for each fetus
✓Crown-rump length confirming each fetus is within the screening window
✓Chorionicity and amnionicity stated
✓Fetal labeling convention documented so measurements map to fetuses
✓Certified sonographer and interpreting physician identified
✓Signed interpretation covering every fetus measured
Global package rules
76814 is billed outside the global obstetric package and separately from 59400. It attaches only to 76813; it has no relationship to the first trimester scan add-on 76802, which pairs with 76801. NCCI
TC-26 components
Mirror the component split used on 76813. In an overread arrangement the credentialed interpreting physician bills both the primary and the add-on with modifier 26 while the scanning site bills the technical components.
76814
Global: one entity owns equipment and interpretation
76814-26
Professional: interpretation only
76814-TC
Technical: equipment and technologist
Reimbursement
2026 · national Medicare averages
Component
Work RVU
Total RVU
2026 rate
76814Global
0.97
2.24
$74.82
76814-26Professional
0.97
1.42
$47.43
76814-TCTechnical
0.00
0.82
$27.39
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 76813
Why it happens
76814 appeared without its primary code on the claim, or the primary line denied on credentialing and the add-on followed.
How to fix
Bill 76814 only alongside 76813 from the same session, and clear any credentialing denial on the primary first.
Source: NCCI
N290Provider not NT-certified
Why it happens
The rendering provider's NTQR or FMF credential could not be verified for the additional-fetus measurement.
How to fix
The same certification covers all fetuses in the session. Verify the credential is current and resubmit under the correct rendering NPI.
Source: AIUM
CO-50Multiple gestation not supported
Why it happens
Diagnosis codes described a singleton while an additional-fetus add-on was billed.
How to fix
Correct the ICD-10 codes to the documented multiple gestation and resubmit.
Source: CMS
CO-16Units exceed documented fetuses
Why it happens
More units of 76814 were billed than additional fetuses with completed measurements.
How to fix
Bill one unit per additional fetus with a documented, technically adequate NT measurement. Correct the units and resubmit.
Source: CMS
FAQ
What is the CPT code description for 76814?
In plain language, 76814 covers the nuchal translucency measurement of each additional fetus in a multiple pregnancy. The first fetus is billed with 76813 and each extra fetus with a completed measurement adds one unit of 76814.
Can 76814 be billed alone?
No. It is an add-on code payable only with 76813 from the same session.
What if the NT measurement fails for one twin?
Bill only for the fetuses with technically adequate, documented measurements. If twin B could not be measured, the claim is 76813 alone, and a return visit within the window can be billed when the measurement is completed.
Do certification rules apply to the add-on?
Yes. The NTQR or FMF credentialing requirement follows the study, so every fetus measured must be measured and interpreted by certified providers.
Does 76814 take modifier 51?
No. Add-on codes are exempt from the multiple-procedure reduction; appending 51 invites rejections.
Is 76814 part of the global OB package?
No. All obstetric ultrasounds, including screening add-ons, are billed separately from 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.