How To Use CPT Code 59412

CPT 59412 describes the procedure known as external cephalic version, which is performed by a healthcare provider to attempt to turn the fetus into a head-first position before delivery. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 59412?

CPT 59412 is used to describe the procedure called external cephalic version. This procedure involves a healthcare provider attempting to manually turn the fetus into a head-first position before delivery. The provider may use tocolysis, which is a drug to suppress contractions, while performing the procedure. The provider uses their hands on the woman’s abdomen to maneuver the fetus into the desired position.

2. Official Description

The official description of CPT code 59412 is: ‘External cephalic version, with or without tocolysis (List in addition to code[s] for delivery).’ This code should be used in addition to the appropriate codes for delivery.

3. Procedure

1. After monitoring the patient for at least thirty minutes to assess fetal wellbeing, the healthcare provider positions the patient in the supine position.
2. The provider performs a limited ultrasound to verify the baby’s position, the position of the placenta, and the amniotic fluid volume.
3. A drug may be administered to stop or prevent uterine contractions.
4. Once the provider confirms optimal fetal heart rate and the absence of contractions, they use both hands on the surface of the mother’s abdomen to push and roll the fetus into a head-down, or cephalic, position.
5. The provider continuously monitors the baby’s heart rate and uses an ultrasound transducer to check on the progress.
6. After successfully turning the fetus into the head-down position, the provider performs a final ultrasound to verify the position.

4. Qualifying circumstances

CPT 59412 is performed on patients who have a fetus in a breech or transverse lie position and wish to attempt a vaginal birth. The procedure is typically performed by a healthcare provider who is experienced in external cephalic version. It is important to note that the version does not have to be successful to report CPT 59412, and a modifier 52, Reduced Service, should not be added if the procedure is unsuccessful.

5. When to use CPT code 59412

CPT code 59412 should be used when a healthcare provider performs the external cephalic version procedure, with or without tocolysis, to attempt to turn the fetus into a head-first position before delivery. It is important to use this code in addition to the appropriate codes for delivery.

6. Documentation requirements

To support a claim for CPT 59412, the healthcare provider must document the following information:

• Monitoring of the patient for fetal wellbeing for at least thirty minutes
• Positioning of the patient in the supine position
• Limited ultrasound to verify fetal position, placenta position, and amniotic fluid volume
• Administration of tocolysis, if applicable
• Confirmation of optimal fetal heart rate and absence of contractions
• Maneuvering of the fetus into a head-down position using hands on the mother’s abdomen
• Continuous monitoring of the baby’s heart rate and progress using an ultrasound transducer
• Final ultrasound to verify the position after successful version

7. Billing guidelines

When billing for CPT 59412, ensure that the procedure is performed by a healthcare provider experienced in external cephalic version. It is important to use this code in addition to the appropriate codes for delivery. Modifier 52, Reduced Service, should not be added if the procedure is unsuccessful.

8. Historical information

CPT 59412 was added to the Current Procedural Terminology system on January 1, 1990. The code has undergone a change on January 1, 2002, which added the note to list it in addition to code(s) for delivery.

9. Examples

1. A healthcare provider performs external cephalic version on a patient with a breech fetus to attempt a vaginal birth.
2. During the external cephalic version procedure, the healthcare provider uses tocolysis to suppress contractions and successfully turns the fetus into a head-first position.
3. A patient with a transverse lie fetus undergoes external cephalic version to increase the chances of a vaginal delivery.
4. After monitoring the patient and confirming optimal fetal heart rate, the healthcare provider performs external cephalic version to turn the fetus into a cephalic position.
5. A healthcare provider performs external cephalic version on a patient who desires a vaginal birth but has a breech fetus.
6. During the external cephalic version procedure, the healthcare provider uses ultrasound to verify the position of the fetus and placenta.
7. A patient with a breech fetus undergoes external cephalic version to attempt a vaginal delivery.
8. The healthcare provider successfully turns the fetus into a head-first position during the external cephalic version procedure.
9. After confirming the absence of contractions, the healthcare provider performs external cephalic version to turn the fetus into a cephalic position.
10. A patient with a transverse lie fetus undergoes external cephalic version to increase the chances of a successful vaginal delivery.