CPT® Code 59852

1. Indications

The procedure described by CPT® Code 59852 is indicated in specific clinical scenarios where an induced abortion is necessary. The following conditions may warrant the use of this procedure:

• Therapeutic Abortion - This procedure is performed when there are medical indications that necessitate the termination of the pregnancy for the health and safety of the mother or fetus.
• Failed Intra-Amniotic Injection - The procedure is indicated when initial attempts at inducing abortion through intra-amniotic injections have not been successful, necessitating a surgical intervention.

2. Procedure

The procedure for CPT® Code 59852 involves several critical steps that are executed in a structured manner to ensure safety and effectiveness. Each step is detailed as follows:

• Step 1: Hospital Admission - The patient is admitted to the hospital for the procedure, where she will be monitored closely throughout the process. This admission includes an assessment of her medical history and current health status.
• Step 2: Anesthesia Administration - A local anesthetic is administered at the planned puncture site for the amniocentesis. This step is crucial for minimizing discomfort during the procedure.
• Step 3: Amniocentesis - A needle is introduced into the amniotic sac, and a cannula is inserted through the needle. The needle is then withdrawn, allowing for the administration of the first intra-amniotic injection.
• Step 4: Intra-Amniotic Injection - The first injection is performed, which is intended to cause fetal demise and induce labor. This step is critical for initiating the abortion process.
• Step 5: Monitoring - Continuous monitoring of uterine and fetal activity is conducted, along with the vital signs of the mother, to ensure that the procedure is proceeding safely.
• Step 6: Additional Injections - If the initial injection does not achieve the desired outcome, additional intra-amniotic injections may be administered to stimulate uterine contractions and facilitate the abortion.
• Step 7: Hysterotomy - If it becomes evident that the intra-amniotic injections have failed, a hysterotomy is performed. This involves making an incision in the abdomen to access the uterus.
• Step 8: Fetus and Placenta Removal - The uterus is incised, and the physician removes the fetus and placenta. This step is essential to ensure that all products of conception are extracted.
• Step 9: Inspection and Closure - The placenta is examined, and the uterus is inspected to confirm that all products of conception have been removed. The uterine incision is then closed, followed by the closure of the abdominal layers in a layered fashion.

3. Post-Procedure

After the completion of the procedure, the patient will require monitoring in a hospital setting to assess recovery and ensure there are no complications. Post-procedure care may include pain management, monitoring for signs of infection, and ensuring that the patient is stable before discharge. Follow-up visits may be scheduled to evaluate the patient's recovery and address any ongoing health concerns. It is important for the healthcare team to provide the patient with information regarding what to expect during recovery and any signs or symptoms that should prompt immediate medical attention.