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Facility billing labor checks

  1. Question Facility billing labor checks
    Medical Coding Books
    I would appreciate any advise related to facility billing for labor checks.

    External fetal monitoring is standard practice for pregnant women who present to the ER and are sent to L&D. The facility is not doing a fetal non-stress test CPT 59025. External monitoring is placed on the patient to see if the patient is having contractions. Although the fetal heart rate is monitored with the contractions, there is no assessment for fetal response or fetal movements, and no official report is generated. The implication is that the fetus is not at risk, and this is not an assessment of fetal status. It is basically a check to see if the patient is having contractions, a “labor check.”

    Is 59025 with modifier 52 (reduced services) appended appropriate or the unlisted code 59899?

  2. #2
    I just had a webinar with the provider side of this question - the 59025-52 would be appropriate and for the facility you would also need modifier TC as well I believe.

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