Summary & Overview
CPT 59851: Inpatient Intra‑amniotic Pregnancy Termination and D&C
CPT code 59851 defines an inpatient, post-first-trimester method of pregnancy termination in which a provider injects saline into the amniotic sac to cause fetal demise, manages the subsequent labor, performs dilation and curettage, and follows the patient until discharge. This global procedure is clinically significant because it covers a comprehensive episode of care for pregnancies at or beyond 14 weeks gestation and is typically delivered in an acute hospital setting. Its use has implications for hospital resource allocation, inpatient obstetric scheduling, and payer coverage policies.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical and service context for 59851, a summary of common billing modifiers used with this code, and a discussion of typical site-of-service considerations. The publication also outlines how this code fits into inpatient obstetric service lines and what stakeholders should note about the code’s scope and clinical elements. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 59851 describes a global obstetric procedure in which the provider terminates a pregnancy of at least fourteen weeks gestation by administering an intra-amniotic saline injection to induce fetal demise, managing the ensuing labor, performing dilation and curettage, admitting the patient to the hospital, and providing inpatient follow-up until discharge.
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Service type: Inpatient obstetric termination with intra-amniotic injection, labor management, and dilation and curettage
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Typical site of service: Hospital inpatient setting
Clinical & Coding Specifications
Clinical Context
A typical patient is a twenty-eight-year-old gravida 2 para 0 at 16 weeks 3 days gestation who presents to the hospital for elective termination of pregnancy after counseling. The patient is admitted to an inpatient obstetric unit. The clinical workflow includes admission and informed consent, baseline vital signs and fetal assessment (ultrasound confirmation of gestational age and amniotic sac location), placement of intravenous access, administration of intra-amniotic hypertonic saline or other approved solution under ultrasound guidance to induce fetal demise, and monitoring during the labor process. The provider manages pain control and labor progression, performs a dilation and curettage once the cervix is adequately dilated and fetal demise has occurred, and provides postoperative inpatient monitoring until discharge. Nursing documentation includes intake/output, pain scores, fetal heart monitoring (if applicable before demise), medication administration, and discharge instructions. Typical site of service is an inpatient hospital labor and delivery unit; the service type is a global inpatient obstetric surgical procedure covering admission, intra-amniotic injection, labor management, D&C, and inpatient follow-up until discharge.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default main claim indicator | Rarely appended by providers; used by some payors to indicate the main claim line |