CPT® Code 59020

The fetal contraction stress test, identified by CPT® Code 59020, is a diagnostic procedure used to assess the fetal heart rate response to uterine contractions. This test is also referred to as an oxytocin challenge test. During the procedure, two belts equipped with sensors are placed around the patient's abdomen. One belt is designed to monitor the fetal heart rate, while the other measures the timing and duration of uterine contractions. These sensors are connected via wires to a recording device that captures and displays the fetal heart rate alongside the strength and duration of the contractions. If the fetus changes position, the heart rate monitor may be adjusted accordingly to ensure accurate readings. The test typically lasts for 10 minutes, during which the fetal heart rate and any spontaneous uterine contractions are recorded on an external fetal monitor. If no spontaneous contractions occur within this timeframe, an intravenous infusion of oxytocin, commonly known as Pitocin, is administered. The infusion starts at a low dose and is gradually increased until three contractions are recorded within a 10-minute period, with each contraction lasting longer than 45 seconds. Alternatively, breast massage or nipple stimulation may be employed to induce contractions naturally, as this method encourages the body to produce oxytocin. The patient manually massages her nipple until contractions begin, and if a second contraction does not occur within 2 minutes, further stimulation is applied. If contractions do not manifest within 15 minutes, both nipples may be stimulated, with the procedure being repeated on one breast for a maximum of 10 minutes. It is important to note that while nipple stimulation can be effective, it may lead to prolonged and uncontrolled contractions, prompting some physicians to prefer the oxytocin infusion method for its controlled approach.