Medical Billing Dilemma – When to Use Fetal NST Code 59025

It is better to make sure the patient recorded when she first felt the baby moving; otherwise, it is better to count the fetal monitoring as routine.

When you report a 59025 Fetal Non-Stress Test for NST procedures, you need to be sure you are reporting them in the appropriate situations. During an NST procedure, the OB-GYN evaluates the patient and assesses the well being of a fetus without using IV medications. The test usually lasts about 30-40 minutes, during which the OB-GYN will monitor the fetal heart rate using external transducers. A “reactive” NST will show that the fetal heart rate accelerated from the base line fifteen beats per minute for a minimum of fifteen seconds, at least two times during a ten-minute window.

If there are no accelerations after twenty minutes, the OB-GYN may attempt to include a fetal response. The most important factor is that the patient marks the fetal movements. The OB-GYN interprets the strip and writes or dictates a report that he or she must include in the patient’s record. For example, if your OB-GYN sees a patient that complains that her fetus has not been moving around much in the last few weeks, and she is at 31 weeks gestation, then during the first twenty minutes of monitoring, the OB-GYN uses the external transducers and detects no heart rate acceleration. Then the OB-GYN uses an electronic larynx to stimulate the fetus, and the mother marks the strip where she feels movement. You should report this service with 59025 because the doctor is using the NST in order to determine the status of the fetus.

When you report a 59025, make sure you have supporting documentation to justify this code, and not just a pregnancy code. Most payers will not cover an NST unless the doctor has provided a specific reason. Don’t use 59025 for labor checks either. This should be included as part of labor management or global OB package.

View all Articles by: Melissa Clark, CCS-P