How To Use CPT Code 59866

CPT 59866 describes the procedure of multifetal pregnancy reduction (MPR), which involves reducing a higher order multifetal gestation pregnancy to either a twin or singleton pregnancy. This article will cover the description, official terminology, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 59866?

CPT 59866 can be used to describe the procedure of multifetal pregnancy reduction (MPR), where a higher order multifetal gestation pregnancy is reduced to either a twin or singleton pregnancy. This code is used when a provider performs the necessary steps to increase the chances of a successful pregnancy for the remaining fetuses and prevent serious complications associated with higher order gestations.

2. Official Description

The official description of CPT code 59866 is: ‘Multifetal pregnancy reduction(s) (MPR).’ This code is used when a provider performs the procedure to reduce a higher order multifetal gestation pregnancy to either a twin or singleton pregnancy.

3. Procedure

1. Before beginning the procedure, the provider conducts an ultrasound to assess the viability of all the fetuses and selects the ones to be reduced.
2. The provider preps and drapes the abdominal area and administers a local anesthetic at the needle insertion site.
3. Using ultrasound guidance, the provider inserts a needle into the thorax of the selected fetus and injects potassium chloride to stop the fetal heartbeat.
4. The provider then moves the needle into the amniotic sac, removing the fluid surrounding the fetus.
5. This process is repeated for each fetus to be reduced.
6. After completing the procedure, the provider removes the needle from the mother’s abdomen.
7. A follow-up ultrasound is performed to verify the remaining fetuses have a heartbeat.

4. Qualifying circumstances

CPT 59866 is performed when a higher order multifetal gestation pregnancy needs to be reduced to increase the chances of a successful pregnancy for the remaining fetuses and prevent complications associated with higher order gestations. The procedure is typically performed by a provider who has the necessary training and expertise in performing multifetal pregnancy reduction.

5. When to use CPT code 59866

CPT code 59866 should be used when a provider performs the procedure of multifetal pregnancy reduction to reduce a higher order multifetal gestation pregnancy to either a twin or singleton pregnancy. It is important to note that this code should not be used for other procedures or interventions related to maternity care and delivery.

6. Documentation requirements

To support a claim for CPT 59866, the provider must document the following information:

• Viability assessment of all fetuses and selection of fetuses to be reduced
• Use of ultrasound guidance during the procedure
• Injection of potassium chloride to stop the fetal heartbeat
• Removal of fluid from the amniotic sac
• Confirmation of remaining fetuses’ heartbeat through a follow-up ultrasound

7. Billing guidelines

When billing for CPT 59866, ensure that the procedure is performed by a qualified provider and meets the necessary criteria for multifetal pregnancy reduction. It is important to note that ultrasound guidance during the procedure is included in the code and should not be separately reported. However, pre- and post-procedure ultrasounds should be reported separately. Review the specific billing guidelines provided by payers to ensure accurate and appropriate reimbursement.

8. Historical information

CPT 59866 was added to the Current Procedural Terminology system on January 1, 1997. There have been no updates or changes to the code since its addition.

9. Examples

1. A provider performs multifetal pregnancy reduction to reduce a higher order multifetal gestation pregnancy to a twin pregnancy.
2. Using ultrasound guidance, a provider performs multifetal pregnancy reduction to reduce a higher order multifetal gestation pregnancy to a singleton pregnancy.
3. After assessing the viability of all fetuses, a provider performs multifetal pregnancy reduction to reduce a higher order multifetal gestation pregnancy to increase the chances of a successful pregnancy for the remaining fetuses.
4. A provider performs multifetal pregnancy reduction to prevent serious complications associated with higher order gestations.
5. Using ultrasound guidance, a provider performs multifetal pregnancy reduction to reduce a higher order multifetal gestation pregnancy and improve the chances of a successful pregnancy for the remaining fetuses.
6. A provider performs multifetal pregnancy reduction to reduce the risks and complications associated with higher order gestations.
7. After careful assessment, a provider performs multifetal pregnancy reduction to increase the chances of a successful pregnancy for the remaining fetuses.
8. Using ultrasound guidance, a provider performs multifetal pregnancy reduction to reduce a higher order multifetal gestation pregnancy and improve the overall outcome.
9. A provider performs multifetal pregnancy reduction to ensure the health and well-being of the remaining fetuses.
10. After thorough evaluation, a provider performs multifetal pregnancy reduction to reduce the risks and improve the outcome of the pregnancy.