CPT 59812: Vaginal Uterine Evacuation for Retained Products of Conception
CPT code 59812 represents a vaginal surgical uterine evacuation performed to remove retained products of conception after a miscarriage. Nationally, this code captures a common gynecologic intervention that affects obstetrics and gynecology service lines and hospital-based surgical care. It is relevant for inpatient and outpatient surgical billing, care coordination, and payer coverage determinations.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find context on clinical use, typical sites of service, and common billing modifiers associated with this type of surgical procedure. The publication outlines national benchmarks and payment policy summaries where available, clarifies coding scope for the procedure, and summarizes clinical circumstances that typically prompt use of the code. This overview is intended for revenue cycle managers, clinicians involved in gynecologic care, and policy analysts seeking a concise reference to how this uterine evacuation procedure is coded and billed at a national level.
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Billing Code Overview
CPT code 59812 describes a surgical procedure to remove retained products of conception following a miscarriage using a vaginal approach. This procedure involves extraction of fetal or placental tissue that has not been expelled spontaneously.
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Service type: Surgical procedure (gynecologic uterine evacuation)
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Typical site of service: Hospital operating room or ambulatory surgical center with gynecologic surgical capability
Clinical & Coding Specifications
Clinical Context
A 32-year-old patient presents to the labor and delivery unit after a spontaneous miscarriage at approximately 10 weeks' gestation. The patient reports heavy vaginal bleeding, cramping, and passage of tissue earlier in the day but retains incomplete products of conception on transvaginal ultrasound. The obstetrician-gynecologist evaluates vital signs, performs a focused pelvic exam, confirms retained tissue likely causing ongoing bleeding and risk of infection, and obtains informed consent for surgical management. The patient is taken to an operating room or ambulatory procedure room for a dilation and suction procedure via the vaginal approach to remove retained products of conception. The clinical workflow includes preoperative assessment, administration of appropriate anesthesia (local, sedation, or general depending on clinical and patient factors), dilation of the cervix as needed, suction curettage or sharp curettage if indicated, hemostasis, postoperative recovery, discharge instructions, and documentation of the procedure, findings, and follow-up plan.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Reserved/invalid (historical) | Not typically reported; present in source list but not used for active billing |
11 | No longer used (replacement for modifier 52 historically) | Not used for this procedure in current CMS billing but listed in source modifiers |
22 | Increased procedural services | Use when work required to perform 59812 is substantially greater than typical (document reasons) |
23 | Unusual anesthesia | Use when circumstances require general anesthesia for 59812 for medical reasons despite it normally being performed with regional/local anesthesia |
25 | Significant, separately identifiable E/M service | Use when a separate evaluation and management service is furnished on the same day as 59812 and meets documentation requirements |
47 | Anesthesia by surgeon | Use when the surgeon personally administers local anesthesia for the procedure and billing rules permit reporting of this modifier |
50 | Bilateral procedure | Not typically applicable to 59812 (single pelvic organ procedure) but included when bilateral procedures are reported on other codes |
51 | Multiple procedures | Use when 59812 is performed in the same session with other reportable procedures and payer requires modifier to indicate multiple procedures |
52 | Reduced services | Use when 59812 is partially reduced or not completed as originally planned (document reason) |
53 | Discontinued procedure | Use when 59812 is started but terminated due to extenuating circumstances or patient condition (document) |
59 | Distinct procedural service | Use to indicate a procedure or service that is separate and distinct from other services performed on the same day when clinically appropriate documentation supports distinctness |
62 | Two surgeons | Use when two surgeons work together as primary surgeons performing distinct portions of 59812 requiring shared operative responsibility |
76 | Repeat procedure by same physician | Use when 59812 is repeated by the same physician subsequent to an earlier procedure in the postoperative period for the same patient |
78 | Return to OR for a related procedure during global period | Use when the patient returns to the operating room for a related procedure due to a complication after 59812 during its global period |
79 | Unrelated procedure or service by the same physician during the global period | Use when another unrelated procedure is performed during the global period for 59812 |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207V00000X | Obstetrics & Gynecology | Most common specialty performing 59812 |
207VC0200X | Obstetrics | Subspecialty focusing on pregnancy-related care; may perform early pregnancy procedures |
207VR0401X | Gynecology | Gynecologists performing surgical management of miscarriage and related procedures |
366A00000X | Family Medicine | Family physicians with maternity/obstetric privileges may perform this procedure in some settings |
208800000X | General Surgery | Rarely involved; included for completeness where surgical obstetric care is delivered by general surgeons in limited settings |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
O03.9 | Complete or unspecified spontaneous abortion without complications | Represents spontaneous abortion where surgical evacuation may be required if incomplete or when retained products are suspected |
O03.8 | Other spontaneous abortion with other complications | Includes spontaneous abortion with complications such as retained products or hemorrhage prompting 59812 |
O02.1 | Missed abortion | Fetal death without expulsion where uterine evacuation such as 59812 is commonly performed |
O03.4 | Incomplete spontaneous abortion with other complications | Retained tissue with bleeding/infection indications for surgical removal via 59812 |
O72.3 | Postpartum hemorrhage following spontaneous abortion | Significant bleeding after miscarriage that may necessitate uterine evacuation with 59812 |
N99.81 | Complications of any gynecological procedure, not elsewhere classified | Used when complications arise from management of miscarriage or from the evacuation procedure itself |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
59812 | Uterine evacuation, postpartum or following miscarriage, incomplete, by dilation and curettage or suction (vaginal approach) | Primary procedure for removal of retained products of conception after miscarriage via vaginal approach |
59400 | Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy and/or forceps) and postpartum care | May be part of overall obstetric care when miscarriage care is integrated into maternity services for patients who were receiving prenatal care |
58120 | Endometrial sampling (biopsy) without cervical dilation | May be performed preoperatively for evaluation of abnormal uterine bleeding or retained tissue when diagnosis is uncertain prior to performing 59812 |
51798 | Measurement of post-void residual urine, non-invasive (e.g., bladder scan) | Performed if bladder dysfunction or urinary retention is suspected post-procedure or during evaluation |
99024 | Postoperative follow-up visit, related to surgery during global period, normally included in global fee | Represents routine postoperative visits associated with 59812 and typically included in the global surgical package |
99152 | Moderate sedation services provided by a physician for patients younger than 5 years or for special circumstances (example code for sedation) | Sedation/anesthesia codes may be reported when moderate or deep sedation is separately reportable for 59812 depending on payer rules |