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Official Description

Treatment of missed abortion, completed surgically; first trimester

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

A missed abortion, also known as a spontaneous abortion, occurs when a fetus has died in utero or is no longer developing but has not been expelled from the uterus. This condition can also be referred to as anembryonic gestation, empty sac, or blighted ovum. The surgical treatment for a missed abortion is typically performed in the first trimester and involves a procedure known as suction curettage. This method is commonly utilized to remove the non-viable fetal tissue and any associated products of conception from the uterus. The procedure is essential to prevent complications that may arise from retained tissue, such as infection or excessive bleeding. The surgical approach is carefully executed to ensure the safety and well-being of the patient while effectively addressing the medical condition at hand.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure coded as CPT® 59820 is indicated for the treatment of a missed abortion, specifically when the fetus has died in utero or is no longer developing but has not been expelled from the uterus. This condition may present with various symptoms, including:

  • Absence of fetal heartbeat - Confirmation through ultrasound that the fetus is no longer viable.
  • Vaginal bleeding - Patients may experience light to heavy bleeding as the body attempts to expel the non-viable tissue.
  • Pelvic pain or cramping - Discomfort may occur as the body reacts to the missed abortion.

2. Procedure

The surgical treatment of a missed abortion involves several critical steps to ensure the safe and effective removal of the retained tissue. The procedure is typically performed as follows:

  • Preparation - The patient is positioned appropriately, and a speculum is inserted into the vagina to allow for visualization of the cervix. The cervix is then cleansed with an antiseptic solution to minimize the risk of infection.
  • Cervical dilation - The anterior cervical lip is grasped with a tenaculum to stabilize the cervix. Local anesthesia is administered to numb the area, and the cervix is dilated using a series of metal rods of increasing diameter, which are gently passed into the cervical canal. Alternatively, a laminaria tent may be inserted into the cervix 8-20 hours prior to the procedure to facilitate gradual dilation.
  • Suction curettage - Once the cervix is adequately dilated, a suction curette is inserted through the cervix. Suction is initiated while the curette is rotated in a full circle several times to effectively remove the tissue. The procedure continues until there is no further passage of tissue and blood through the curette, indicating that the suction evacuation is complete.
  • Sharp curettage (if necessary) - In some cases, sharp curettage may be performed following suction curettage to ensure that all products of conception have been thoroughly removed from the uterus.
  • Post-procedure care - After the procedure, the tenaculum is removed, and any bleeding from the cervix is controlled through the application of pressure. The tissue that has been removed is sent for pathology examination to confirm the diagnosis and rule out any other conditions.

3. Post-Procedure

Following the surgical treatment of a missed abortion, patients are typically monitored for any immediate complications, such as excessive bleeding or signs of infection. Recovery may vary, but patients are generally advised to rest and avoid strenuous activities for a short period. It is important for patients to follow up with their healthcare provider to discuss the pathology results and any further care that may be necessary. Emotional support may also be beneficial, as experiencing a missed abortion can be distressing for many individuals.

Short Descr CARE OF MISCARRIAGE
Medium Descr TX MISSED ABORTION FIRST TRIMESTER SURGICAL
Long Descr Treatment of missed abortion, completed surgically; first trimester
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P5E - Ambulatory procedures - other
MUE 1
CCS Clinical Classification 127 - Dilatation and curettage (D&C), aspiration after delivery or abortion
47 Anesthesia by surgeon: regional or general anesthesia provided by the surgeon may be reported by adding modifier 47 to the basic service. (this does not include local anesthesia.) note: modifier 47 would not be used as a modifier for the anesthesia procedures.
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
GC This service has been performed in part by a resident under the direction of a teaching physician
GY Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
SG Ambulatory surgical center (asc) facility service
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
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