How To Use CPT Code 59074

CPT 59074 describes the procedure of fetal fluid drainage, which involves the removal of excess fluid from the bladder, lungs, or abdominal cavity of the fetus. This article will provide an overview of CPT code 59074, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 59074?

CPT 59074 is used to describe the procedure of fetal fluid drainage, also known as vesicocentesis, thoracocentesis, or paracentesis. This procedure involves the removal of excess fluid that has accumulated in the bladder, lungs, or abdominal cavity of the fetus. It is typically performed using a transabdominal approach and ultrasound guidance to ensure accuracy and safety.

2. Official Description

The official description of CPT code 59074 is: ‘Fetal fluid drainage (eg, vesicocentesis, thoracocentesis, paracentesis), including ultrasound guidance.’

3. Procedure

1. The provider begins by placing the patient in the supine position and preparing the abdomen with an antiseptic solution.
2. A transabdominal transducer is then placed over the lower abdomen to visualize the fetal and placental structures.
3. Color flow Doppler is used to evaluate the abdominal and uterine vascular structures, as well as the fetal and placental vascular structures, to avoid during the drainage procedure.
4. The provider administers a regional or local anesthetic to the patient to ensure their comfort during the procedure.
5. A small abdominal incision is made at the puncture site, and under continuous ultrasound guidance, a cannula is inserted through the mother’s abdominal and uterine wall into the amniotic cavity.
6. The provider positions the cannula to access the umbilical cord of the abnormal fetus and directs the needle into the fetus, ensuring it stays in a perpendicular position to the fluid-filled area that needs to be drained.
7. Color flow Doppler is used again to confirm that no fetal vascular structures are at risk as the needle is advanced.
8. The provider aspirates the excess fluid and may adjust the needle position to complete the drainage.
9. After withdrawing the needle, the provider uses ultrasound to assess the fetal heart rate and inspects the puncture sites for any bleeding.
10. The patient is monitored for a period of time to check for fluid reaccumulation, and the fluid sample is sent to the laboratory for analysis.

4. Qualifying circumstances

CPT 59074 is typically performed on patients who have excess fluid accumulation in the bladder, lungs, or abdominal cavity of the fetus. This procedure is usually indicated when there is a medical need to drain the fluid to improve the health and well-being of the fetus. The use of ultrasound guidance ensures the accuracy and safety of the procedure.

5. When to use CPT code 59074

CPT code 59074 should be used when a provider performs fetal fluid drainage using ultrasound guidance. This code is appropriate when there is a medical necessity to remove excess fluid from the bladder, lungs, or abdominal cavity of the fetus. It is important to note that CPT code 59074 should not be reported if other codes, such as CPT codes 59075 or 59076, have already been performed within the same session.

6. Documentation requirements

To support a claim for CPT code 59074, the provider must document the following information:

• Patient’s medical condition necessitating the fetal fluid drainage
• Use of ultrasound guidance during the procedure
• Date and duration of the procedure
• Specific details of the procedure, including the location of fluid drainage and any adjustments made during the procedure
• Assessment of fetal heart rate and inspection of puncture sites for bleeding
• Monitoring of the patient for fluid reaccumulation
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 59074, it is important to ensure that the procedure was performed using ultrasound guidance. Additionally, it should not be reported if other related codes have already been billed within the same session. It is recommended to review the specific billing guidelines provided by the payer to ensure accurate and appropriate reimbursement for the procedure.

8. Historical information

CPT code 59074 was added to the Current Procedural Terminology system on January 1, 2004. There have been no updates or changes to the code since its addition.

9. Examples

1. A provider performs fetal fluid drainage to remove excess fluid from the bladder of a fetus with a diagnosed urinary obstruction.
2. Using ultrasound guidance, a provider drains fluid from the lungs of a fetus with diagnosed pleural effusion.
3. A provider performs fetal fluid drainage to remove excess fluid from the abdominal cavity of a fetus with diagnosed ascites.
4. Using ultrasound guidance, a provider drains fluid from the lungs of a fetus with diagnosed hydrops fetalis.
5. A provider performs fetal fluid drainage to remove excess fluid from the bladder of a fetus with diagnosed bladder outlet obstruction.
6. Using ultrasound guidance, a provider drains fluid from the abdominal cavity of a fetus with diagnosed meconium peritonitis.
7. A provider performs fetal fluid drainage to remove excess fluid from the lungs of a fetus with diagnosed congenital pulmonary airway malformation.
8. Using ultrasound guidance, a provider drains fluid from the abdominal cavity of a fetus with diagnosed gastroschisis.
9. A provider performs fetal fluid drainage to remove excess fluid from the bladder of a fetus with diagnosed posterior urethral valves.
10. Using ultrasound guidance, a provider drains fluid from the lungs of a fetus with diagnosed congenital diaphragmatic hernia.