Summary & Overview
CPT 59820: Vaginal Uterine Evacuation for Early Intrauterine Fetal Demise
CPT code 59820 denotes a vaginal uterine evacuation procedure for confirmed intrauterine fetal death prior to 14 weeks gestation. Nationally, this code is used to capture surgical management of early fetal demise and is relevant for hospitals, ambulatory surgery centers, and outpatient clinics providing gynecologic surgical care. Accurate coding supports appropriate claims processing, quality measurement, and tracking of reproductive health services.
Major payers in scope include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise description of clinical use and service settings for 59820, common payer coverage considerations, and the typical modifiers encountered for surgical and professional billing. The publication also outlines expected documentation elements tied to the procedure and summarizes areas where policy updates or payer-specific rules commonly affect claim adjudication.
This summary equips billing managers, coding professionals, and policy analysts with the clinical context and coding identity of 59820, facilitating consistent reporting and review of reimbursement and compliance practices at a national level. Data not available in the input.
Billing Code Overview
CPT code 59820 describes a surgical procedure in which the provider confirms intrauterine fetal death and performs removal of the fetus and all products of conception via a vaginal approach when the gestational age is less than fourteen weeks and zero days. This procedure involves evacuation of the uterine contents through the cervix and is typically performed to manage early fetal demise.
-
Service type: Surgical procedure, uterine evacuation for early intrauterine fetal demise
-
Typical site of service: Hospital outpatient department, ambulatory surgery center, or outpatient clinic with appropriate surgical capability
Clinical & Coding Specifications
Clinical Context
A 28-year-old G2P1 woman at estimated gestational age 10 weeks presents to the outpatient gynecology clinic with absent fetal cardiac activity on transvaginal ultrasound and cramping vaginal bleeding. The clinician documents intrauterine fetal demise prior to 14 weeks 0 days gestation and counsels the patient on management options. The chosen management is surgical completion via vacuum aspiration and curettage performed through a vaginal approach. Preoperative workflow includes informed consent, pregnancy location confirmation by ultrasound, Rh typing and Rho(D) immune globulin administration if indicated, pre-procedure vital signs and assessment for anesthesia risk, and verification of sterilization and instrument availability. The patient is taken to an ambulatory procedure suite or same-day operating room; monitored anesthesia care or local anesthesia with sedation is provided. The provider performs cervical dilation as needed, vacuum aspiration, and uterine curettage to remove the fetus and all products of conception. Post-procedure monitoring includes hemostasis assessment, pain control, discharge instructions, and scheduling of follow-up care and contraceptive counseling as appropriate. Typical site of service is an outpatient ambulatory surgery center or hospital outpatient department.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier applicable (placeholder in some systems) | Rarely used; included by some payors as a default when no other modifier applies. |