Medical Billing with 59025

Using the medical billing code 59025 can be a sticky situation. This is an example of a current procedural terminology code that is often misused in medical billing offices. There are certain instances when the code 59025 is appropriate, and other times it is not appropriate in medical billing.

The medical billing code 59025 means fetal non-stress test. A non-stress test is used to detect accelerations in the fetal heart rate over a 20-40 minute window. If no accelerations are found, the physician uses instruments to stimulate the baby or wake the baby up into a moving state. To be considered a true non-stress test in medical billing, these elements, along with the patient’s fetal monitoring record, are required for submission.

When deciding to code for 59025, it is important to determine whether or not the procedure was indeed a fetal non-stress test, or merely a routine labor check. Similar monitoring devices are used during both instances. It is not appropriate to use 59025 for a mere labor check. This is routine and will quickly get your medical billing denied since the fetal monitoring is usually a part of the maternity global billing.

Usually, the only time it is appropriate to use the code 59025 in medical billing is if the OB-Gyn has a documented reason for performing the procedure. For instance, if the mother hasn’t felt much movement or if the physician detects a weak heartbeat. In these instances CPT 59025 would be appropriate. You medical billing staff members should know this rule.

The job of your medical billing department is to accurately and efficiently code and process claims. Correct reimbursement is essential in medical billing. You do not want needless medical billing claims denied due to the improper use of the CPT code 59025.

View all Articles by: Melissa Clark, CCS-P