Summary & Overview
CPT 59841: Second-Trimester Dilation and Evacuation with Forceps
CPT code 59841 represents a second-trimester dilation and evacuation (D&E) performed via a vaginal approach in which the cervix is dilated and the fetus and products of conception are removed using forceps. The code covers elective and therapeutic pregnancy terminations performed between 14 weeks, 0 days and less than 28 weeks, 0 days. Nationally, this code is clinically significant because it defines billing for a time-sensitive gynecologic surgical service that requires surgical facilities, trained providers, and perioperative care.
Key payers addressed in this publication include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and typical sites of service for CPT code 59841, a summary of common billing modifiers associated with operative gynecologic services (provided in the input), and guidance on the types of benchmarks and policy updates commonly relevant to second-trimester surgical abortion services. The content outlines expected service delivery settings (hospital operating room or ambulatory surgical center) and highlights that care involves operative gynecology and anesthesia resources.
This publication is intended for billing and compliance teams, clinical administrators, and policy analysts seeking a clear, national-level reference on CPT code 59841, including what the code represents, where the service is typically performed, and which major payers are commonly involved. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 59841 describes a deliberate termination of pregnancy performed via a vaginal approach during the second trimester (from 14 weeks, 0 days to less than 28 weeks, 0 days). The provider dilates the cervix and evacuates the fetus and products of conception using forceps. This procedure is an operative gynecologic service performed for elective or therapeutic reasons.
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Service type: Second-trimester surgical abortion by dilation and evacuation with forceps
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Typical site of service: Hospital operating room or ambulatory surgical center with appropriate surgical and anesthesia support
Clinical & Coding Specifications
Clinical Context
A 22–24-week pregnant patient presents to an ambulatory surgical center or hospital gynecology unit seeking termination of pregnancy for therapeutic or elective reasons. After informed consent and preoperative evaluation (history, physical, Rh status, ultrasound confirmation of gestational age and fetal presentation, baseline labs including CBC and blood type), the patient undergoes cervical preparation (osmotic dilators or pharmacologic agents) followed by dilation and evacuation under regional or general anesthesia. The provider dilates the cervix and evacuates fetal and placental tissue using forceps and suction curettage via a transvaginal approach. Postoperative monitoring includes vital signs, uterine tone assessment, bleeding evaluation, analgesia, Rh immunoglobulin administration if indicated, and discharge instructions with follow-up arranged in clinic within 1–2 weeks. Typical site of service is an operating room or ambulatory surgical center with capabilities for second‑trimester procedures and emergency support; inpatient hospital admission is used if complications occur or for concurrent medical issues.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Standard professional and technical components combined | Rarely used; not typically applied to surgical procedures that are not split component services |