Summary & Overview
CPT 59850: Inpatient Intra-amniotic Induction and Delivery after 14 Weeks
CPT code 59850 designates an inpatient obstetric procedure for termination of pregnancy after 14 weeks’ gestation by intra-amniotic injection of a saline solution to induce fetal demise, followed by management of labor and delivery of the fetus and placenta with inpatient follow-up until discharge. This code matters nationally because it captures a complex, resource-intensive hospital service that intersects clinical care, maternal health policy, and payer coverage determinations. It is used to document and bill complete care for later-term pregnancy termination managed in a hospital setting.
Key payers in national analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context for when this procedure is used (typically after the first trimester), the expected inpatient site of service, and the scope of care represented by the global billing descriptor. The publication also summarizes benchmarking and coverage considerations across major payers, highlights relevant coding practice points for hospital-based obstetric teams, and outlines areas where policy updates and payer-specific rules commonly affect authorization and reimbursement. Data not available in the input are noted where applicable.
Billing Code Overview
CPT code 59850 describes a global obstetric procedure in which the provider induces fetal demise by administering a saline solution into the amniotic sac (intra-amniotic injection). The procedure includes hospital admission, performance of the intra-amniotic injections to cause fetal demise, management of the labor that follows, delivery of the fetus and placenta, and inpatient follow-up until discharge.
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Service type: Inpatient obstetric procedure for pregnancy termination after the first trimester
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Typical site of service: Hospital inpatient setting
Clinical & Coding Specifications
Clinical Context
A 29-year-old G2P1 woman at 18 weeks 3 days gestation presents to the labor and delivery unit with a planned second‑trimester termination for fetal anomalies identified on ultrasound. Pre-procedure evaluation includes informed consent, review of ultrasound to confirm gestational age and amniotic fluid volume, Rh typing and administration of Rho(D) immune globulin if indicated, baseline vital signs, and review of anesthesia and surgical risks. The patient is admitted to an inpatient obstetric unit or surgical ward. Under continuous maternal monitoring, the obstetric provider performs intra‑amniotic injection of a hypertonic saline solution to induce fetal demise. The provider documents the injection procedure, monitors for contractions and maternal hemodynamic stability, manages analgesia or anesthesia as needed, and allows labor to progress. When labor is complete, the provider delivers the fetus and placenta, ensures uterine tone and hemostasis, and provides postpartum monitoring and discharge instructions. The typical site of service is an inpatient hospital or designated hospital outpatient department with obstetric capabilities.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default - no modifier | Use when no special circumstances apply and the full global service is billed |
11 |