Summary & Overview
CPT 59000: Amniocentesis, Amniotic Fluid Sampling
CPT code 59000 denotes amniocentesis, a diagnostic fetal procedure involving percutaneous transabdominal needle aspiration of amniotic fluid for genetic, chromosomal, metabolic, or infectious testing. Nationally, amniocentesis remains a critical tool in prenatal diagnosis, guiding pregnancy management and informing parental decision-making. Use of this code affects clinical documentation, preauthorization workflows, and payer coverage determinations across public and commercial plans. Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will gain a concise understanding of the clinical context and coding purpose of 59000, typical sites of service where the procedure is performed, and the payer landscape that commonly covers amniocentesis. The publication also provides benchmarking and policy-relevant material, including coverage considerations and coding practice implications for hospitals, ambulatory surgical centers, and maternal-fetal medicine providers. Where data are not provided in the source input, the summary notes that information is unavailable. The content is intended for a national audience of coding specialists, billing managers, and clinical leaders seeking a clear, practical reference for CPT code 59000.
Billing Code Overview
CPT code 59000 describes amniocentesis, a diagnostic procedure in which a provider inserts a needle through the patient’s abdominal wall into the fetal amniotic sac to withdraw amniotic fluid for testing. The procedure is performed to obtain fetal cells and biochemical markers for genetic, chromosomal, metabolic, or infectious assessment.
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Service type: Diagnostic fetal procedure (amniotic fluid sampling)
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Typical site of service: Hospital or ambulatory surgical center; may also be performed in specialized outpatient maternal-fetal medicine clinics
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Clinical & Coding Specifications
Clinical Context
A 34-year-old pregnant woman at 16 weeks’ gestation presents to maternal-fetal medicine for evaluation after abnormal first-trimester screening indicating increased risk for trisomy 21. The patient has received counseling regarding diagnostic testing options. After informed consent, the maternal-fetal medicine specialist performs an amniocentesis to obtain amniotic fluid for genetic analysis. The procedure is performed in an outpatient ambulatory surgery center or hospital labor and delivery unit with continuous fetal monitoring, ultrasound guidance, and sterile technique. Pre-procedure workflow includes verification of gestational age, review of prior ultrasound for placental location and fetal number, obtaining baseline maternal vital signs and fetal heart rate, anticoagulation and infection history screening, informed consent, and availability of emergency equipment. Post-procedure workflow includes brief observation with fetal monitoring, wound care instructions, laboratory handling of amniotic fluid specimens, documentation of indication, technique, ultrasound guidance, fetal heart tones before and after, and any immediate complications such as leakage of fluid, bleeding, or uterine cramping.
Coding Specifications
| Modifier | Description | When to Use |
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25 | Significant, separately identifiable evaluation and management (E/M) service by the same physician on the day of a procedure | Use when a distinct E/M visit (e.g., informed consent, pre-procedure assessment) is performed the same day as the amniocentesis. |
| | Distinct procedural service | Use when amniocentesis is reported with another procedure on the same day and the services are separate and independent.