We received a patient from the ER who presented with severe pelvic pain. The HCG indicated pregnancy, but there was no intrauterine pregnancy so an ectopic is suspected. What is the correct CPT® code for this scenario?
According to the American Medical Association (AMA) and the American College of Radiology (ACR), the procedure would be reported with an OB ultrasound code because the patient had a positive pregnancy test and symptoms that could be related to a pregnancy. If the maternal uterus and adnexa are documented along with a statement that a gestational sac, yolk sac or fetal pole could not be visualized, then code 76801 is assigned. If the patient presented to the department with the aforementioned pain but without a positive pregnancy test a non-obstetric pelvic code—76856 or 76857—would be assigned.
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