CPT® Code 59850

Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines;

An induced abortion, commonly known as a therapeutic abortion, is a medical procedure that involves the termination of a pregnancy through the use of one or more intra-amniotic injections, also referred to as amniocentesis injections. This method is specifically utilized for patients who are in the second trimester of pregnancy. The agents that may be injected or instilled during this procedure include hypertonic saline, hypertonic urea, or prostaglandin F2a, which are substances that help induce labor and fetal demise. The procedure encompasses several components, including hospital admission, physician visits, and the delivery of both the fetus and the secundines, which are the membranes and tissues associated with the pregnancy. Prior to the induced abortion, cervical preparation is often necessary, which may involve the insertion of laminaria, prostaglandin, or other cervical dilators into the cervix eight to twenty-four hours before the procedure. This preparation is crucial for ensuring adequate cervical dilation. Once the cervix is confirmed to be dilated, the procedure proceeds with the cleansing of the abdomen and the identification of a pocket of amniotic fluid via ultrasound. A needle is then carefully inserted into this pocket to facilitate the injection of the chosen agent. In some cases, a local anesthetic may be administered at the site of the planned amniocentesis puncture to minimize discomfort. Following the injection, the procedure includes monitoring uterine and fetal activity, as well as the vital signs of the mother. If necessary, additional intra-amniotic injections may be administered. The delivery of the fetus and placenta occurs vaginally, and the products of conception are inspected to confirm the completeness of the abortion. If an incomplete abortion is identified, a dilation and curettage or evacuation may be performed to ensure that all tissue is removed from the uterus. This comprehensive approach ensures that the procedure is conducted safely and effectively, adhering to the necessary medical protocols.