🩺 CPT Code 76512: Documentation & Billing Guide

76512: B-scan w or wo non-quantitative A-scan

⚡ Quick Reference

Metric	Value	Notes
Global	XXX	(Standard check)
wRVU	0.58 professional
Assist	No	(Standard policy)

🚧 Bundling & NCCI Edits

(What is INCLUDED in this code?)

Includes:
Mutually Exclusive:

📝 MCW/Payer Specifics

Medical Necessity: Documentation must support ophthalmology complexity.
Mod -22: If applicable, look for >50% extra time/effort (e.g., BMI >40, extensive adhesions).
Category: This is a OPHTHALMOLOGY specific procedure.

CPT Code Analysis: 76512

CPT/HCPCS Code(s):

76512 - Ophthalmic ultrasound, diagnostic; B-scan with or without superimposed non-quantitative A-scan: This is a diagnostic procedure used to visualize the internal structures of the eye and orbit using high-frequency sound waves.
- WRVU: 0.58 (Professional Component) / 2.28 (Global/Total) for 2025.
- Global Period: XXX (The global surgery concept does not apply to diagnostic tests).
- Bundling & NCCI Edits:
  - Inclusives: Superimposed non-quantitative A-scans are bundled into the B-scan.
  - Mutually Exclusive: 76512 is bundled with 76513 (Ophthalmic ultrasound, diagnostic; anterior segment ultrasound biomicroscopy); they should not be reported together for the same eye.
- Explanation: Used primarily for posterior segment evaluation when the view is obscured (e.g., dense cataract or vitreous hemorrhage) or to evaluate specific lesions.

ICD-10-CM Code(s): The following are the top 3 common diagnosis codes that support medical necessity for this procedure:

H33.2- - Serous retinal detachment: Used when clinical examination cannot confirm the presence or extent of a detachment due to opaque media.
H43.1- - Vitreous hemorrhage: Often the primary reason for a B-scan to rule out underlying retinal tears or detachments when the retina is not visible.
C69.2- - Malignant neoplasm of retina: Used for the detection, measurement, and monitoring of intraocular tumors or masses.

Clinical Use Case Distinction

76512 (B-Scan): Appropriate for posterior/orbital anatomy, such as the retina, choroid, vitreous chamber, optic nerve head, and orbital soft tissues.
76513 (UBM): Appropriate for anterior segment anatomy (e.g., iris, ciliary body, anterior chamber angle) typically imaged with high-frequency “immersion” techniques.

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