CPT 59855, in plain terms, covers A medical procedure to end a pregnancy using medication administered through the vagina, performed after the first trimester. CPT 59855 is referenced in 6 tracked payer policy changes from Health Net. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 59855 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.
Official descriptor: CPT 59855 on AAPC
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