Code Description
CPT code 59025 describes a fetal non-stress test (NST). This is a common antepartum test performed to monitor fetal well-being by measuring the fetal heart rate in response to its movements. The test is typically conducted during the third trimester for high-risk pregnancies or when there is concern for fetal distress. The procedure involves external fetal heart rate monitoring without inducing contractions. CPT 59025 covers the setup, monitoring, and interpretation of the test.
Purpose
The purpose of CPT 59025 is to evaluate fetal health by assessing heart rate patterns and responsiveness. It helps detect fetal hypoxia, distress, or other complications to guide obstetric management and ensure timely interventions if necessary.
Clinical Scenarios Where CPT 59025 is Applicable
- High-risk pregnancies such as preeclampsia, diabetes, or decreased fetal movements
- Post-term pregnancies requiring fetal surveillance
- Assessment of fetal well-being in cases of intrauterine growth restriction (IUGR) or other concerns
- Monitoring fetal status in pregnancies complicated by hypertension or placental insufficiency
Procedure Overview
- Patient is positioned comfortably, usually in a semi-recumbent or lateral position.
- Application of an external fetal heart rate monitor and a tocodynamometer to the abdomen
- Continuous monitoring of fetal heart rate and movements for at least 20 minutes
- Documentation of reactive or non-reactive fetal heart rate patterns based on established criteria
Documentation Requirements For Fetal Non-Stress Test
- Start and end time of the NST procedure.
- Indications for testing and clinical context
- Detailed interpretation of fetal heart rate patterns and any abnormalities
- Patient response and any follow-up recommendations
Billing and Reimbursement Tips Under The CPT Code 59025
- CPT 59025 should be billed once per session, regardless of duration, unless medically necessary to repeat
- Verify payer policies on the number of allowable NSTs per pregnancy.
- Use appropriate modifiers when billing for services alongside other antepartum testing or procedures performed on the same day.
- Ensure clinical documentation justifies the medical necessity of the test to avoid denial.s
Medicare Coverage and Reimbursement for CPT 59025
Medicare generally covers CPT 59025 when medically necessary as part of antepartum fetal surveillance. Reimbursement rates vary by locality and are determined by the Medicare Physician Fee Schedule. Providers should confirm coverage and payment with their local Medicare Administrative Contractor. Documentation of medical necessity and detailed interpretation support proper reimbursement.
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At BillingFreedom, we specialize in obstetric billing, including CPT 59025 fetal monitoring. Our certified billing professionals ensure precise coding and thorough documentation to:
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Related ICD-10-CM Codes
ICD-10-CM Codes
O09.00 - Supervision of pregnancy with history of infertility, unspecified trimester
O09.01 - Supervision of pregnancy with history of infertility, first trimester
O09.02 - Supervision of pregnancy with history of infertility, second trimester
O09.523 - Supervision of elderly multigravida, third trimester
O09.529 - Supervision of elderly multigravida, unspecified trimester
O09.611 - Supervision of young primigravida, first trimester
O10.011 - Pre-existing essential hypertension complicating pregnancy, first trimester
O10.012 - Pre-existing essential hypertension complicating pregnancy, second trimester
O10.013 - Pre-existing essential hypertension complicating pregnancy, third trimester
P56.0 - Hydrops fetalis due to isoimmunization
P56.90 - Hydrops fetalis due to unspecified hemolytic disease
P56.99 - Hydrops fetalis due to other hemolytic disease
P57.0 - Kernicterus due to isoimmunization
Z34.00 - Encounter for supervision of normal first pregnancy, unspecified trimester
Z34.01 - Encounter for supervision of normal first pregnancy, first trimester
Z34.02 - Encounter for supervision of normal first pregnancy, second trimester
Z34.03 - Encounter for supervision of normal first pregnancy, third trimester
Z34.80 - Encounter for supervision of other normal pregnancy, unspecified trimester
Z34.81 - Encounter for supervision of other normal pregnancy, first trimester
Z34.82 - Encounter for supervision of other normal pregnancy, second trimester
Z34.83 - Encounter for supervision of other normal pregnancy, third trimester
Z34.90 - Encounter for supervision of normal pregnancy, unspecified, unspecified trimester
Related CPT Codes
CPT Codes
59425 - Vaginal Delivery with Postpartum Care
59525 - Hysterectomy After Cesarean (Add-On)
59414 - Delivery of Placenta Only
59514 - Cesarean Delivery Only
59614 - Vaginal Delivery After Previous Cesarean Delivery with Postpartum Care
59400 - Routine Obstetric Care. Vaginal Delivery, Antepartum and Postpartum Care Procedures
59510 - Cesarean Delivery with Antepartum and Postpartum Care