Coding Question of the Month

February 2018: Foley/Cook’s Catheters for Cervical Ripening

QUESTION: Can CPT code 59200 be reported when Foley/Cook's catheters are used for cervical ripening to induce labor? The lay description states 59200 is to be used to “chemically stimulate and dilate the cervical canal” with laminaria or prostaglandin. Utilizing a Foley or Cook’s catheter does not seem to follow the “chemical” description of the code since this is a mechanical dilation and laminaria are not utilized.

ANSWER: The description for code 59200, Insertion of cervical dilator (eg, laminaria, prostaglandin) (separate procedure), cites laminaria and prostaglandin as examples, but these two are not the only options for cervical ripening. CPT instructions state: “When reporting codes for services provided, it is important to assure the accuracy and quality of coding through verification of the intent of the code by use of the related guidelines, parenthetical instructions, and coding resources, including CPT Assistant and other publications resulting from collaborative efforts of the American Medical Association with the medical specialty societies.”

The CPT Assistant published in its December 2017 issue an article that recommends reporting code 59200 for cervical ripening to induce labor using a Foley or Cook’s catheter. ACOG has been consulted by the AMA regarding this topic and endorses the advice as it appears on the article. If this service is performed on the same day as a delivery, it is considered part of the global obstetric package and cannot be reported separately. However, if it is done one day or more prior to the delivery, it can be coded with modifier 59 or other appropriate X{EPSU} sub-modifier per payer policy.


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Donna Tyler
Director, Coding

Joyce Kilgore
Facility Coding Education Specialist

Miroslava Rudneva
Coding Education Specialist

Tatyana Mallory
Facility Coding Education Specialist


American College of Obstetricians and Gynecologists
409 12th Street SW, Washington, DC  20024-2188 | Mailing Address: PO Box 70620, Washington, DC 20024-9998