Aetna's Clinical Policy Bulletin 0530 covers transvaginal ultrasonography (TVUS), and its policy history shows a last review date of 08/20/2026. Aetna considers TVUS medically necessary for indications including assessment of fetal viability and gestational age in the first trimester when viability is uncertain, assessment of a pelvic mass, evaluation of abnormal uterine bleeding, diagnosis of ectopic pregnancy, evaluation of pelvic pain of suspected gynecologic origin, evaluation of infertility, guidance during embryo transfer, and verifying IUD position when the string is not visible. Aetna considers TVUS experimental, investigational or unproven for screening for endometrial cancer, ovarian cancer or other gynecologic cancers, and for preoperative prediction of lymph node metastasis in cervical cancer. Pelvic ultrasound is considered clinically integral to the transvaginal examination and does not warrant separate reimbursement.
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01Billing team: Bill CPT 76817 or 76830 for transvaginal ultrasound only when the selection criteria are met, meaning the visit documents one of the medically necessary indications in this policy.
02Do not bill a separate abdominal pelvic ultrasound when TVUS is performed on a patient whose pelvic structures are within the bony pelvis, because the policy calls it duplicative.
03Do not bill CPT 76830 for confirming IUD placement after insertion, which the policy excludes.
04Do not bill TVUS for screening for endometrial, ovarian or other gynecologic cancers, which the policy lists as experimental, investigational or unproven.
05Use a diagnosis code that matches the documented indication in charge entry, since the policy lists screening codes Z12.73 and Z12.79 as not covered for these indications.
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