How To Use CPT Code 59820

CPT 59820 is a code used for the treatment of missed abortion in the first trimester, completed surgically. This article will cover the description, procedure, qualifying circumstances, when to use the code, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 59820 procedures.

1. What is CPT 59820?

CPT 59820 is a medical code used to describe the surgical treatment of a missed abortion in the first trimester. A missed abortion occurs when the fetus dies in utero, or in the uterus before birth, and the gestational age is less than fourteen weeks and zero days. The provider then surgically removes the fetus and all of the products of conception via a vaginal approach.

2. 59820 CPT code description

The official description of CPT code 59820 is: “Treatment of missed abortion, completed surgically; first trimester.”

3. Procedure

1. The patient is placed in a dorsal lithotomy position.
2. General or regional anesthesia is administered.
3. A weighted speculum is inserted, and the cervix is cleansed.
4. Serial dilation of the cervix is performed using mechanical dilators.
5. The uterine cavity is emptied of the dead fetus and all products of conception using a manual or electric suction aspirator.
6. A curette may be used to remove additional tissue from the uterine cavity.
7. All products of conception are sent to pathology for confirmation of completeness.
8. Instruments are withdrawn, and bleeding is controlled.

4. Qualifying circumstances

Patients eligible to receive CPT code 59820 services are those who have experienced a missed abortion in the first trimester, with a gestational age of less than fourteen weeks and zero days. The fetus must have died in utero, and the provider must determine that surgical intervention is necessary to remove the fetus and all products of conception.

5. When to use CPT code 59820

It is appropriate to bill the 59820 CPT code when a provider has determined that a patient has experienced a missed abortion in the first trimester and requires surgical intervention to remove the dead fetus and all products of conception. The gestational age must be less than fourteen weeks and zero days for this code to be applicable.

6. Documentation requirements

To support a claim for CPT 59820, the following information must be documented:

• Patient’s medical history and physical examination findings
• Confirmation of missed abortion diagnosis, including gestational age
• Indication for surgical intervention
• Details of the procedure, including anesthesia, dilation, and removal of products of conception
• Pathology report confirming the completeness of the removed products of conception
• Postoperative care and follow-up instructions

7. Billing guidelines

When billing for CPT code 59820, it is essential to ensure that the patient meets the qualifying circumstances and that the procedure is medically necessary. Proper documentation must be maintained to support the claim. Additionally, be aware of any payer-specific guidelines or requirements that may apply to the billing of this code.

8. Historical information

CPT 59820 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 59820

Five similar codes to CPT 59820 and how they differentiate are:

1. CPT 59812: Treatment of incomplete abortion, any trimester, completed surgically.
2. CPT 59821: Treatment of missed abortion, completed surgically; second trimester.
3. CPT 59160: Curettage, postpartum, which is performed after delivery to remove retained placental tissue or to control bleeding.
4. CPT 59840: Induced abortion by dilation and curettage, which is performed to terminate a pregnancy.
5. CPT 59841: Induced abortion by dilation and evacuation, which is performed to terminate a pregnancy in the second trimester.

10. Examples

Here are 10 detailed examples of CPT code 59820 procedures:

1. A 32-year-old woman with a confirmed missed abortion at 10 weeks gestation undergoes surgical treatment to remove the dead fetus and products of conception.
2. A 28-year-old woman with a history of recurrent miscarriages experiences a missed abortion at 12 weeks gestation and requires surgical intervention.
3. A 35-year-old woman with a missed abortion at 9 weeks gestation undergoes the procedure due to heavy bleeding and the risk of infection.
4. A 25-year-old woman with a missed abortion at 11 weeks gestation undergoes surgical treatment after failed medical management with misoprostol.
5. A 30-year-old woman with a missed abortion at 13 weeks gestation undergoes the procedure due to severe abdominal pain and the risk of infection.
6. A 27-year-old woman with a missed abortion at 8 weeks gestation undergoes surgical treatment after an ultrasound confirms the absence of fetal heartbeat.
7. A 31-year-old woman with a missed abortion at 7 weeks gestation undergoes the procedure due to heavy bleeding and the risk of hemorrhage.
8. A 29-year-old woman with a missed abortion at 6 weeks gestation undergoes surgical treatment after failed medical management with misoprostol.
9. A 33-year-old woman with a missed abortion at 5 weeks gestation undergoes the procedure due to severe abdominal pain and the risk of infection.
10. A 26-year-old woman with a missed abortion at 14 weeks gestation undergoes surgical treatment after an ultrasound confirms the absence of fetal heartbeat.