Summary & Overview
CPT 59140: Removal of Cervical Ectopic Pregnancy, Vaginal Approach
CPT code 59140 represents a targeted operative gynecologic procedure: removal of an ectopic pregnancy lodged in the cervical canal using a vaginal approach. This is a specialized, often urgent, procedure that addresses a rare but high-risk form of ectopic gestation. Nationally, accurate coding for this service is important for clinical documentation, surgical resource allocation, and payer adjudication given the procedure’s potential for hemorrhage and need for operative care.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for cervical ectopic removal, typical sites of service (hospital OR or ambulatory surgical center via vaginal approach), and common billing considerations. The publication also covers payer coverage patterns, allowable and denial trends where available, and benchmark metrics for utilization and reimbursement.
Intended readers will learn how CPT code 59140 is used in claims, the clinical circumstances that justify the service, and the types of documentation and coding precision that influence claim outcomes. Data limitations are noted where input information is not available. The content is framed for a national audience and focuses on coding clarity, clinical context, and payer relevance rather than specific practice recommendations.
Billing Code Overview
CPT code 59140 describes a surgical procedure to remove an ectopic pregnancy located in the cervical canal. The procedure is performed via a vaginal approach, with the provider directly removing the ectopic gestation lodged in the cervix.
Service type: Operative gynecologic procedure
Typical site of service: Hospital operating room or ambulatory surgical center (vaginal surgical setting)
Clinical & Coding Specifications
Clinical Context
A typical patient is a woman of reproductive age presenting to the emergency department or gynecology clinic with vaginal bleeding, pelvic cramping, and a positive pregnancy test. Transvaginal ultrasound demonstrates an ectopic gestation localized within the cervical canal. The clinical team includes an obstetrician-gynecologist experienced in operative vaginal procedures. Initial workflow includes stabilization, hemodynamic assessment, and counseling about risks (bleeding, infection, need for further surgery). Preoperative steps include type and screen, informed consent, and administration of prophylactic antibiotics per facility protocol. The procedure is performed via a vaginal approach under regional or general anesthesia in an operating room or procedure suite; the provider removes the ectopic products from the cervical canal using suction curettage, grasping instruments, or cerclage/ligation techniques as indicated. Post-procedure monitoring focuses on bleeding control, pain management, and confirmation of declining beta-hCG levels; follow-up includes repeat quantitative beta-hCG and evaluation for retained products or infection. Typical site of service is an operating room or ambulatory surgery center with gynecologic capability, and the service type is operative gynecologic procedure (removal of cervical ectopic pregnancy).
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Primary procedure | When this cervical ectopic removal is the primary service on the claim |
22 | Increased procedural services | For significantly greater-than-usual work, e.g., extensive hemorrhage control or prolonged operative time |
23 | Unusual anesthesia | When general anesthesia is required because local/regional is contraindicated due to patient factors |
50 | Bilateral procedure | Not typically applicable; include only if a bilateral procedure unrelated to this code is reported on same date |
51 | Multiple procedures | When additional unrelated procedures are performed on the same day (to indicate reduced reimbursement for secondary procedures) |
52 | Reduced services | If the procedure is partially performed or aborted (e.g., incomplete removal due to instability) |
53 | Discontinued procedure | When the procedure is terminated after it has begun for patient safety reasons |
62 | Two surgeons | When a second surgeon with distinct skills is required (e.g., complex hemorrhage control with gynecologic oncology assistance) |
76 | Repeat procedure by same provider | When the same provider repeats the procedure on the same day for a related reason |
77 | Repeat procedure by another provider | When another provider repeats the procedure on the same day |
78 | Unplanned return to OR | For a return to the operating room for a related procedure during the global period (e.g., control of delayed hemorrhage) |
80 | Assistant surgeon | When an assistant surgeon provides substantial intraoperative assistance |
81 | Minimum assistant surgeon | When a minimal assistant role is performed |
GT | Telehealth — originating site | Not applicable to the intraoperative procedure itself; used only for synchronous telehealth services when applicable |
26 | Professional component | If separate professional interpretation or consultative component is billed distinct from the facility service |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207V00000X | Obstetrics & Gynecology | Primary specialty performing removal of cervical ectopic pregnancies |
| 207VP0102X | Gynecologic Oncology | May be involved for complex hemorrhage control or extensive reconstruction |
| 207RC0000X | Reproductive Endocrinology/Infertility | May participate when fertility-preserving techniques are prioritized |
| 2080S0124X | Family Medicine | In some settings family physicians with procedural training may perform the procedure |
| 207L00000X | Maternal & Fetal Medicine | May be consulted for high-risk pregnancy implications |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
O00.1 | Tubal and ovarian pregnancy, unspecified | Represents ectopic pregnancy variants; differentiates non-cervical ectopic locations |
O00.8 | Other ectopic pregnancy | Covers ectopic pregnancies in less common locations including cervical canal when specific code not used |
O00.9 | Ectopic pregnancy, unspecified | Used when exact ectopic site not yet specified but ectopic pregnancy is confirmed |
O02.1 | Missed abortion | May be considered in differential if products of conception are suspected within cervical canal but diagnostic clarification needed |
O03.9 | Spontaneous abortion without complication | Relevant for coding concurrent or differential diagnoses when bleeding in early pregnancy occurs |
N72 | Inflammation of cervix uteri | May be a coexisting cervical condition affecting approach or healing after the procedure |
R87.610 | Abnormal cytology of cervix — low grade | May be present as unrelated cervical findings identified during evaluation |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
59812 | Dilation and curettage, postpartum | Rarely related; sometimes billed for retained products or extensive curettage following cervical ectopic removal when clinical circumstances overlap |
58120 | Dilation and curettage, diagnostic and/or therapeutic (nonobstetrical) | Often performed adjunctively to ensure removal of products from the uterine cavity if cavity evaluation is indicated after cervical ectopic removal |
59135 | Suction dilation and curettage of uterus for ectopic pregnancy (non-cervical) | Related ectopic management code; used when ectopic pregnancy is managed by uterine suction rather than cervical canal-specific removal |
59820 | Cervical cerclage removal | May be used if cerclage or suture ligation placed or removed as part of hemorrhage control during the procedure |
36415 | Collection of venous blood by venipuncture | Common ancillary service for preoperative labs, type and screen, and quantitative beta-hCG monitoring |
99024 | Postoperative follow-up visit, global period | Used for routine postoperative follow-up visits within the global surgical period |