CPT 59840: First-Trimester Surgical Abortion by Suction Curettage
CPT code 59840 denotes a first-trimester surgical abortion performed by dilating the cervix and removing the fetus and products of conception using suction curettage via a vaginal approach. Nationally, this code is a primary procedural identifier for early pregnancy termination performed for elective or therapeutic reasons and is relevant for clinical coding, quality monitoring, and reimbursement across outpatient surgical settings. Key payers commonly involved in coverage and claims adjudication for this service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of how the code is used in clinical practice, typical sites of service, and payer patterns; summaries of common billing modifiers and claim considerations; and context on related procedural coding that may appear on surgical service lines. The publication addresses benchmarking and policy-relevant issues tied to coding consistency and documentation requirements, and it provides clinical context necessary for accurate claim submission and recordkeeping. Data not available in the input for associated taxonomies, specific ICD-10 diagnoses, and related codes is noted where applicable.
Sign up for cpt 59840 policy alerts
Get alerted when payer policies referencing 59840 are released or updated.
Billing Code Overview
CPT code 59840 describes a procedure in which the provider deliberately terminates a pregnancy by dilating the cervix and removing the fetus and products of conception using a suction curette via a vaginal approach. This procedure is typically performed for elective or therapeutic reasons during the first trimester, defined as less than fourteen complete weeks of gestation.
-
Service type: First-trimester surgical abortion performed via suction and curettage
-
Typical site of service: Ambulatory surgical center or hospital outpatient department; may also be performed in an outpatient clinic with appropriate surgical capabilities
Clinical & Coding Specifications
Clinical Context
A 26-year-old patient presents to an outpatient ambulatory surgical center seeking elective termination of a confirmed intrauterine pregnancy at 9 weeks' gestation. After pre-procedure counseling and informed consent, the patient undergoes preoperative assessment including vital signs, ultrasound confirmation of gestational age and intrauterine location, and routine laboratory testing per facility protocol. In the procedure room, the patient receives local cervical anesthesia and moderate sedation administered and monitored by the anesthesia team. The provider dilates the cervix and performs a suction curettage via a vaginal approach to evacuate the uterine contents. Hemostasis is confirmed, post-procedure recovery monitoring occurs, and discharge instructions with follow-up are provided.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Unspecified modifier | Rarely used; vendor-specific default when no other modifier applies |
11 | Typically not a standard CMS modifier; used by some payors for primary service reporting | Use only if payer requires for primary procedure identification |
22 | Increased procedural services | When work or time substantially exceeds typical for 59840 |
23 | Unusual anesthesia | When a procedure that normally does not require general anesthesia requires it due to patient condition |
25 | Significant, separately identifiable E/M service by same physician on same day | When pre-procedure evaluation or counseling is above and beyond usual pre-op care |
50 | Bilateral procedure | If a bilateral anatomic procedure applies (rare for this code) — generally not used for 59840 |
51 | Multiple procedures | When 59840 is billed with additional distinct procedures during same operative session |
52 | Reduced services | When the procedure is partially reduced or not completed as described |
53 | Discontinued procedure | Procedure started but terminated due to extenuating circumstances |
54 | Surgical care only | When only the surgeon's portion is billed and another provider bills pre/post op care |
55 | Postoperative management only | When only post-op care is billed by the surgeon |
56 | Preoperative management only | When only pre-op management is billed by the surgeon |
59 | Distinct procedural service | When another procedure on the same day is separate and not bundled with 59840 |
62 | Two surgeons | When two surgeons with distinct roles perform the procedure |
76 | Repeat procedure by same physician | When 59840 is repeated by the same physician during the same day |
78 | Return to OR for related procedure during global period | For surgical revision or complication requiring return to OR |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207V00000X | Obstetrics & Gynecology | Primary specialty performing first-trimester surgical terminations |
207VP2500X | Family Planning (Obstetrics & Gynecology subspecialty) | Providers focused on reproductive health and abortion care |
208D00000X | General Practice | Some family physicians provide office-based first-trimester procedures |
207L00000X | Reproductive Endocrinology/Infertility | Occasionally involved if overlap with reproductive services |
208000000X | Anesthesiology | Provides sedation/anesthesia services during the procedure |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
O04.9 | Complication following abortion, unspecified | Relevant if complications occur post-procedure requiring additional care |
O04.89 | Other complications following therapeutic abortion | Captures specific noninfectious complications after termination |
Z33.2 | Encounter for elective termination of pregnancy | Direct reason for performing 59840 in elective contexts |
O02.1 | Missed abortion | May prompt surgical evacuation via suction curettage if diagnosed in first trimester |
O03.9 | Spontaneous abortion, incomplete or complete, unspecified | Incomplete spontaneous abortion can require surgical management similar to 59840 |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
99152 | Moderate sedation services provided by the same physician performing the diagnostic or therapeutic service that the sedation supports, initial 15 minutes | Used when the operating clinician provides moderate sedation during 59840 (billing rules vary by payer) |
99153 | Moderate sedation services provided by the same physician, each additional 15 minutes | Billed for additional sedation time beyond the initial 15 minutes during the procedure |
99024 | Postoperative follow-up visit, normally included in global fee | Not separately billable during global period unless modifier applies; relevant for documenting post-op care |
A4641 | Materials for irrigation and cleansing of wound (supply code) | Supplies used during uterine evacuation (billing depends on facility and payer policy) |
01991 | Anesthesia for abortion procedures, first trimester | Used when separate anesthesia services are provided and billed for the procedure |