How To Use CPT Code 59001

CPT 59001 describes the therapeutic amniotic fluid reduction procedure, which involves the withdrawal of excess amniotic fluid from the fetal amniotic sac to treat a condition called polyhydramnios. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 59001?

CPT 59001 is used to describe the therapeutic amniotic fluid reduction procedure. This procedure involves the insertion of a needle through the patient’s abdominal wall into the fetal amniotic sac to withdraw excess amniotic fluid. It is typically performed to treat polyhydramnios, a condition characterized by an excess of amniotic fluid.

2. Official Description

The official description of CPT code 59001 is: ‘Amniocentesis; therapeutic amniotic fluid reduction (includes ultrasound guidance).’ This procedure includes the use of real-time ultrasound scanning to guide the provider during the fluid reduction process.

3. Procedure

1. The provider begins by draping and prepping the patient’s abdominal area.
2. Using ultrasound guidance, the provider identifies the needle insertion site.
3. Slowly and carefully, the provider inserts a needle into the amniotic sac.
4. An assistant attaches the needle to tubing, which is then connected to a drainage system.
5. Under continuous ultrasonic guidance, the provider removes the excess amniotic fluid until a normal fluid level is observed on the ultrasound.
6. The provider maintains constant communication with the ultrasound technician to monitor the status of the fetus and the fluid level.
7. Once a normal fluid level is achieved, the provider removes the needle.

4. Qualifying circumstances

CPT 59001 is performed in cases where the patient has been diagnosed with polyhydramnios, which is characterized by an excess of amniotic fluid. The procedure is typically performed by a provider who is skilled in using ultrasound guidance and has the necessary expertise to safely perform the amniotic fluid reduction. It is important to note that code 59001 includes the ultrasound guidance, so code 76942 should not be reported in addition to 59001.

5. When to use CPT code 59001

CPT code 59001 should be used when a therapeutic amniotic fluid reduction procedure is performed to treat polyhydramnios. It is important to ensure that the excess amniotic fluid has been confirmed through diagnostic testing before proceeding with the therapeutic reduction. This code should not be used for diagnostic amniocentesis procedures.

6. Documentation requirements

To support a claim for CPT 59001, the provider must document the following information:

• Patient’s diagnosis of polyhydramnios
• Confirmation of excess amniotic fluid through diagnostic testing
• Date of the procedure
• Details of the procedure, including the use of ultrasound guidance
• Fluid level observed on the ultrasound before and after the reduction
• Communication with the ultrasound technician during the procedure
• Any complications or adverse events that occurred
• Provider’s signature

7. Billing guidelines

When billing for CPT 59001, it is important to ensure that the procedure meets the criteria for therapeutic amniotic fluid reduction for polyhydramnios. The use of ultrasound guidance is included in this code, so code 76942 should not be reported separately. It is also important to follow any specific billing guidelines provided by the payer or Medicare to ensure accurate reimbursement.

8. Historical information

CPT 59001 was added to the Current Procedural Terminology system on January 1, 2002. There have been no updates or changes to the code since its addition.

9. Examples

1. A provider performs a therapeutic amniotic fluid reduction procedure for a patient diagnosed with polyhydramnios.
2. Using ultrasound guidance, the provider carefully withdraws excess amniotic fluid from the fetal amniotic sac to achieve a normal fluid level.
3. The procedure is successful, and the patient’s condition improves as a result of the fluid reduction.
4. Another provider performs a therapeutic amniotic fluid reduction procedure for a patient with severe polyhydramnios.
5. Under continuous ultrasound guidance, the provider removes the excess amniotic fluid, relieving the patient’s discomfort and reducing the risk of complications.
6. The procedure is documented and reported using CPT code 59001.
7. A different provider performs a therapeutic amniotic fluid reduction procedure for a patient with recurrent polyhydramnios.
8. The provider uses real-time ultrasound scanning to guide the procedure and ensure the safe removal of excess amniotic fluid.
9. The patient’s condition improves following the procedure, and the fluid level remains within the normal range.
10. The provider documents the procedure and submits a claim using CPT code 59001.