How To Use CPT Code 59812

CPT 59812 refers to the treatment of incomplete abortion, completed surgically, and this article will cover its description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples.

1. What is CPT 59812?

CPT 59812 is a medical procedure code used to describe the surgical treatment of an incomplete abortion. This code is utilized by medical professionals to accurately document and bill for the services provided during the treatment of a patient who has experienced an incomplete abortion.

2. 59812 CPT code description

The official description of CPT code 59812 is: “Treatment of incomplete abortion, any trimester, completed surgically.”

3. Procedure

The 59812 procedure involves the following steps:

1. Positioning the patient in a dorsal lithotomy position and administering general or regional anesthesia.
2. Inserting a weighted speculum and cleansing the cervix.
3. Performing serial dilation of the cervix using mechanical dilators if the cervix is closed.
4. Emptying the uterine cavity of all products of conception using either a manual or electric suction aspirator.
5. Sending the removed products of conception to pathology for confirmation of completeness.
6. Withdrawing the instruments and controlling bleeding.

4. Qualifying circumstances

Patients eligible to receive CPT code 59812 services are those who have experienced an incomplete abortion during any trimester. This procedure is typically performed in the first trimester (less than thirteen weeks and zero days gestation) but can also be used in the second trimester (fourteen weeks, zero days to less than 28 weeks and zero days). If the procedure is performed after twenty weeks and zero days, a modifier 22 (Increased procedural services) may be appropriate if the provider documents significant additional work.

5. When to use CPT code 59812

It is appropriate to bill the 59812 CPT code when a provider surgically treats an incomplete abortion during any trimester. The code should be used to accurately document and bill for the services provided during the treatment of a patient who has experienced an incomplete abortion and requires surgical intervention to remove the remaining products of conception.

6. Documentation requirements

To support a claim for CPT 59812, the following information should be documented:

• Patient’s medical history and presenting symptoms.
• Physical examination findings, including the size and position of the uterus.
• Confirmation of incomplete abortion through diagnostic tests such as ultrasound or laboratory tests.
• Details of the procedure performed, including anesthesia used, instruments utilized, and any complications encountered.
• Pathology report confirming the completeness of the removed products of conception.
• Postoperative care instructions and follow-up plan.

7. Billing guidelines

When billing for CPT code 59812, it is essential to follow the appropriate guidelines and rules. These may include:

• Using the correct CPT code to accurately describe the procedure performed.
• Documenting all necessary information to support the claim, as outlined in the documentation requirements section.
• Applying modifier 22 (Increased procedural services) if the procedure is performed after twenty weeks and zero days and the provider documents significant additional work.
• Ensuring that the billed services are medically necessary and supported by the patient’s medical record.

8. Historical information

CPT 59812 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Similar codes to CPT 59812

Five similar codes to CPT 59812 and how they differentiate are:

• CPT 59820: This code is used for the treatment of a complete abortion, which differs from the incomplete abortion treated with CPT 59812.
• CPT 59821: This code describes the treatment of a missed abortion, where the fetus has died but has not been expelled from the uterus.
• CPT 59840: This code is used for an induced abortion by dilation and curettage, which is a different procedure than the suction aspiration used in CPT 59812.
• CPT 59841: This code refers to an induced abortion by dilation and evacuation, another distinct procedure from the one described by CPT 59812.
• CPT 59850: This code is used for the treatment of an ectopic pregnancy, which is a different condition than an incomplete abortion.

10. Examples

Here are 10 detailed examples of CPT code 59812 procedures:

1. A patient presents with heavy bleeding and cramping after a spontaneous miscarriage at 10 weeks gestation. The provider performs a surgical treatment using CPT 59812 to remove the remaining products of conception.
2. A patient experiences an incomplete abortion at 16 weeks gestation and undergoes a CPT 59812 procedure to remove the remaining products of conception.
3. A patient with a history of recurrent miscarriages presents with an incomplete abortion at 12 weeks gestation. The provider performs a CPT 59812 procedure to remove the remaining products of conception.
4. A patient presents with an incomplete abortion at 18 weeks gestation and undergoes a CPT 59812 procedure with significant additional work, requiring the use of modifier 22.
5. A patient experiences an incomplete abortion at 8 weeks gestation and undergoes a CPT 59812 procedure to remove the remaining products of conception.
6. A patient presents with an incomplete abortion at 20 weeks gestation and undergoes a CPT 59812 procedure with significant additional work, requiring the use of modifier 22.
7. A patient with a history of uterine fibroids experiences an incomplete abortion at 14 weeks gestation and undergoes a CPT 59812 procedure to remove the remaining products of conception.
8. A patient presents with an incomplete abortion at 22 weeks gestation and undergoes a CPT 59812 procedure with significant additional work, requiring the use of modifier 22.
9. A patient experiences an incomplete abortion at 6 weeks gestation and undergoes a CPT 59812 procedure to remove the remaining products of conception.
10. A patient presents with an incomplete abortion at 24 weeks gestation and undergoes a CPT 59812 procedure with significant additional work, requiring the use of modifier 22.