Summary & Overview
CPT 59830: Removal of Products of Conception for Severe Uterine Infection
CPT code 59830 denotes a vaginal surgical procedure to remove products of conception that are causing a severe uterine infection. This intervention is clinically important because retained gestational tissue with infection can lead to sepsis, hemorrhage, and prolonged morbidity if not evacuated. Nationally, 59830 is a focused, acute gynecologic procedure performed in hospital settings and is relevant to obstetrics and gynecology, emergency care, and inpatient surgical services.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise review of the clinical context for use of CPT code 59830, typical sites of service, common modifiers encountered on claims, and the payer landscape addressed. The publication offers benchmarks where available, summarizes policy considerations that affect coverage and payment for acute evacuation procedures, and outlines coding and billing nuances that influence claim adjudication and reimbursement. The content is designed to inform coding professionals, practice managers, and policy analysts about clinical indications, administrative considerations, and payer coverage trends related to this acute gynecologic surgical code.
Billing Code Overview
CPT code 59830 describes a surgical procedure in which the provider removes products of conception that are causing a severe uterine infection via a vaginal approach. This procedure is performed to manage persistent intrauterine infection when retained gestational tissue is identified as the source.
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Service type: Surgical gynecologic procedure for removal of retained products of conception
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Typical site of service: Hospital operating room or procedure suite with vaginal approach under appropriate anesthesia
Clinical & Coding Specifications
Clinical Context
A typical patient is a reproductive-age woman presenting to the emergency department or gynecology clinic with fever, lower abdominal pain, uterine tenderness, and purulent vaginal discharge following a recently completed pregnancy event (spontaneous abortion, retained products after delivery, or recent termination). After initial evaluation including vital signs, pelvic exam, laboratory studies (complete blood count, inflammatory markers), pregnancy test, and pelvic ultrasound showing retained products of conception with evidence of endometritis or sepsis, the gynecology team determines that removal of retained products via a vaginal approach is required to control infection and prevent progression to severe sepsis. The clinical workflow includes stabilization (IV fluids, broad-spectrum IV antibiotics), informed consent, preoperative assessment, anesthesia consultation (typically general or regional anesthesia), performance of the procedure in an operating room or procedure suite via suction curettage or sharp curettage transvaginally, intraoperative specimen collection for pathology and culture, and postoperative monitoring with continued antibiotics until clinical improvement. Common settings include the hospital inpatient operating room, ambulatory surgery center for stable patients, or emergency operating room for unstable patients requiring urgent source control.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier; standard reporting | Use when no additional modifier applies to the procedure billing. |