2025 CPT code 59897

Unlisted fetal invasive procedure, including ultrasound guidance.

Use this code only when no other specific CPT code exists for the fetal invasive procedure performed. If a Category III code is available, it should be used instead of this unlisted code. When reporting a procedure with this unlisted code, submit a cover letter explaining the reason for choosing the unlisted code instead of a defined, active code. Include one or more similar codes and compare the service provided to those codes to justify the claim amount being billed. Also include the operative notes or other relevant documentation to strengthen the claim and avoid a potential denial.

Modifiers may be applicable to this code depending on the specific procedure performed. Refer to CPT guidelines for modifier usage.

Medical necessity for this code must be clearly documented. This includes the rationale for performing the fetal invasive procedure, the specific condition being addressed, and the expected benefit to the fetus or mother. Documentation should also support why a specific, existing CPT code could not be used.

The provider performs a fetal invasive procedure while the patient is pregnant or at the time of delivery that is not represented by any other standard CPT code.

In simple words: This code covers a procedure done on a baby still in the womb using tools and ultrasound guidance, when there's no specific code for that procedure.

This code is used for any fetal invasive procedure, including ultrasound guidance, that does not have a specific CPT code.

Example 1: A fetal surgery is performed to correct a birth defect., A fetal blood transfusion is performed., A complex fetal shunt placement is required.

Documentation should include a detailed operative report describing the procedure performed, the indication for the procedure, and any associated ultrasound guidance used. Supporting documentation such as prenatal history and imaging studies should also be included.

  • Revenue Code: P1G
  • Payment Status: Active
  • Specialties:Maternal-Fetal Medicine, Obstetrics and Gynecology
  • Place of Service:Inpatient Hospital, Outpatient Hospital
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