How To Use CPT Code 59200

CPT 59200 describes the insertion of a cervical dilator, such as laminaria or prostaglandin, as a separate procedure. 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 59200?

CPT 59200 can be used to describe the insertion of a cervical dilator, which is a device or drug that is used to dilate the cervix. This procedure is typically performed prior to a gynecological procedure that requires entry into the uterus or to dilate the cervix before delivery. The provider performs this procedure using a vaginal approach.

2. Official Description

The official description of CPT code 59200 is: ‘Insertion of cervical dilator (eg, laminaria, prostaglandin) (separate procedure)’. This code is used when the provider inserts a drug or device that dilates the cervix prior to a gynecological procedure or delivery.

3. Procedure

1. To perform CPT 59200, the provider first places the patient in a lithotomy position, which involves lying on the back with knees bent and spread apart using stirrups.
2. The provider then inserts a speculum into the vaginal canal to hold the vaginal walls apart.
3. If using prostaglandin, the provider opens the package and places the end of the woven applicator behind the cervix to induce labor.
4. If using laminaria, the provider grasps the cervix with a tenaculum and inserts the sterile applicator into the opening of the cervix.
5. Once in place, the device absorbs moisture, expands, and slowly dilates the cervix.
6. Finally, the provider removes the instruments used during the procedure.

4. Qualifying circumstances

CPT 59200 is typically performed when there is a need to dilate the cervix prior to a gynecological procedure or delivery. The procedure may be necessary to facilitate entry into the uterus or to prepare the cervix for labor induction. The provider must use a cervical dilator, such as laminaria or prostaglandin, and perform the procedure using a vaginal approach.

5. When to use CPT code 59200

CPT code 59200 should be used when the provider performs the separate procedure of inserting a cervical dilator, such as laminaria or prostaglandin. It is important to note that this code should not be reported if the purpose of the dilation is to induce or enhance labor, as some payers may not reimburse for this separately in such cases.

6. Documentation requirements

To support a claim for CPT 59200, the provider must document the following information:

• The reason for the cervical dilation procedure
• The specific cervical dilator used (e.g., laminaria, prostaglandin)
• The date of the procedure
• The start and end time of the procedure
• Any complications or additional procedures performed
• The provider’s signature

7. Billing guidelines

When billing for CPT 59200, ensure that the procedure meets the criteria for a separate procedure and that the provider performs the cervical dilation using a vaginal approach. It is important to note that some payers may not reimburse for this procedure if it is performed in conjunction with other gynecological or obstetric procedures. It is also important to consider the specific guidelines and requirements of each payer when reporting CPT 59200.

8. Historical information

CPT 59200 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A provider inserts a laminaria dilator prior to performing a hysteroscopy procedure.
2. A provider places a prostaglandin dilator to prepare the cervix for labor induction.
3. A provider inserts a cervical dilator before performing a dilation and curettage (D&C) procedure.
4. A provider uses a laminaria dilator to prepare the cervix for a surgical abortion.
5. A provider inserts a prostaglandin dilator prior to a scheduled cesarean delivery.
6. A provider performs a cervical dilation procedure using a laminaria dilator before a myomectomy surgery.
7. A provider uses a prostaglandin dilator to prepare the cervix for an endometrial biopsy.
8. A provider inserts a cervical dilator before performing an intrauterine device (IUD) insertion.
9. A provider places a laminaria dilator to prepare the cervix for a cone biopsy procedure.
10. A provider uses a prostaglandin dilator to induce labor in a patient with post-term pregnancy.