Reviewed by certified coders + a maternal-fetal medicine physician / Updated for 2026
OB Coding Guide
OB Coding Guide
obcodingguide.com/codes/59812/
Clinical review: Sina Haeri, MD, MHSA (MFM) · Coder review pending · Drafted July 2026
59812 Procedure
CPT 59812

CPT 59812: Surgical Treatment of Incomplete Miscarriage, First TrimesterSurgical Treatment of Incomplete Miscarriage, First Trimester

The short answer

Use 59812 when a first-trimester pregnancy loss has begun on its own but tissue remains, and the provider surgically completes the miscarriage, typically by suction or sharp curettage. The defining facts are an incomplete spontaneous loss and any-trimester surgical completion under this code family's first entry: loss already in progress, retained tissue, surgical evacuation. A missed miscarriage found before any passage of tissue uses 59820 instead, and medication-managed losses bill E/M, not a surgical code.

Source: CMSSource: ACOGSource: CMS MPFS 2026

When to use 59812

Report 59812 when the clinical picture is an incomplete spontaneous abortion, the medical term for a miscarriage in progress with retained tissue, treated surgically. The patient has bleeding or passage of tissue, ultrasound or exam confirms retained products of conception, and the provider evacuates the uterus. Code selection in this family turns on what the pregnancy was doing when treatment started: already passing (incomplete) is 59812, silent loss with no passage is 59820 for the first trimester, and induced termination has its own codes entirely. Getting this right matters beyond payment; these diagnosis and procedure codes end up in records patients may read, so accuracy is also a matter of care.

Documentation checklist

The record should establish the loss, its incomplete status, and the surgical treatment, in clinical language that will read accurately to the payer and, someday, to the patient.

✓ Gestational age at the time of loss
✓ Findings establishing incomplete status: bleeding or tissue passage plus retained products on ultrasound or exam
✓ Diagnosis coded as incomplete spontaneous abortion, with complications coded where present
✓ Procedure note documenting the evacuation method
✓ Anesthesia and setting recorded
✓ Follow-up plan documented, including emotional-support referrals offered

Global package rules

A pregnancy that ends in the first trimester never reaches the global OB package, so there is no global fee to bill against. Bill the antepartum visits that occurred as individual E/M services (1 to 3 visits is the common case at this gestational age, below the 59425 threshold) plus 59812 for the surgical treatment. The procedure carries its own surgical global period on the fee schedule, so routine post-procedure checks within that window are included, while a later visit for a new problem bills separately. See The Global OB Package, explained. CMS

Reimbursement

2026 · national Medicare averages
ComponentWork RVUTotal RVU2026 rate
59812Procedure4.3310.76$359.39

National amounts under the 2026 Medicare Physician Fee Schedule (non-facility total RVU x $33.4009 conversion factor, no locality/MAC adjustment). Commercial and Medicaid rates differ. Verify current values with your MAC before billing.

Common denials

CO-50 Diagnosis does not support the procedure
Why it happens
The claim carried a threatened-loss or missed-miscarriage diagnosis rather than an incomplete spontaneous abortion, so the code and diagnosis disagreed.
How to fix
Match the pair: incomplete loss with 59812, missed first-trimester loss with 59820. Resubmit with the diagnosis reflecting the documented clinical picture.
Source: CMS
CO-16 Claim missing required details
Why it happens
Date of service, place of service, or the rendering provider was absent or inconsistent on the surgical line.
How to fix
Resubmit with the procedure date, the facility, and the performing provider's NPI.
Source: CMS
CO-97 Post-procedure visit bundled
Why it happens
A routine follow-up check within the procedure's surgical global period was billed as a separate E/M service.
How to fix
Routine post-procedure care is included. Bill separately only for distinct problems, with modifier 24 inside the global window and the new diagnosis on the claim.
Source: NCCI
CO-B15 Same-day E/M denied with the procedure
Why it happens
The visit that led to the procedure was billed without demonstrating a significant, separately identifiable service.
How to fix
When the same-day evaluation did distinct work, diagnosing the loss and counseling on options, document it separately and append modifier 25. Otherwise the visit is part of the procedure decision.
Source: NCCI
CO-197 Authorization missing for the facility setting
Why it happens
Some payers require notification or authorization for surgical management in hospital or ASC settings, even urgent ones.
How to fix
Check the payer's authorization rules for the setting, obtain retro-authorization where the plan allows it for urgent care, and resubmit.
Source: CMS

FAQ

What is the CPT code description for 59812?
In plain language, 59812 covers surgically completing a miscarriage that is already in progress: removing retained pregnancy tissue from the uterus, usually by suction or curettage, after an incomplete first-trimester loss.
How do I choose between 59812 and 59820?
By what the pregnancy was doing at treatment. Bleeding or tissue passage with retained products is an incomplete loss, 59812. A silent first-trimester loss found on ultrasound before anything has passed is a missed loss, 59820.
How is medication management of a miscarriage billed?
Without a surgical procedure, there is no surgical code. Bill the E/M visits for the diagnosis, counseling, and follow-up, with the pregnancy-loss diagnosis. If retained tissue later requires surgical completion, 59812 applies at that point.
How do I bill the prenatal visits that happened before the loss?
As individual E/M services in most cases, since first-trimester care rarely reaches the 4-visit threshold for 59425. The global OB package never applies to a pregnancy that ends this early.
Is a follow-up ultrasound after the procedure separately billable?
Yes, when there is a clinical indication such as continued bleeding, with its own order and report. Routine post-procedure checks without imaging stay inside the surgical global period.
Does the emergency department setting change the code?
No. The procedure code is the same in the ED, hospital, ASC, or office; the place of service and any facility billing change around it.
CPT® is a registered trademark of the American Medical Association. Educational reference only, not billing, legal, or medical advice. Maintained by Ouma Health, a maternal-fetal telemedicine practice. Printed from obcodingguide.com, content current as of July 2026.