CPT 59400, 59409, 59410 – Routine obstetric care including antepartum care, vaginal delivery
- Routine prenatal care in any trimester
- Delivery
- Postpartum care ...
- All routine prenatal visits until delivery (approximately 13 for uncomplicated cases)
- Initial and subsequent history and physical exams
- Recording of weight, blood pressures and fetal heart tones
- Routine chemical urinalysis (CPT codes 81000 and 81002)
- Admission to the hospital including history and physical
What does 59400 stand for?
The Current Procedural Terminology (CPT) code 59400 as maintained by American Medical Association, is a medical procedural code under the range - Vaginal Delivery, Antepartum and Postpartum Care Procedures. Also Know, what is included in pregnancy global billing?
What does the medical code 59400 mean?
The Current Procedural Terminology (CPT®) book identifies the Global OB codes as: 59400 – Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care 59510 – Routine obstetric care including antepartum care, cesarean delivery and postpartum care
What is the global period for 59400?
The global maternity period for vaginal delivery is 49 days (59400, 59410, 59610, & 59614). ii. ii. The global maternity period for cesarean delivery is 90 days (59510, 59515, 59618, & 59622).
What is the CPT code for vacuum assisted vaginal delivery?
Obstetrics Coding and Documentation Reference Guide CPT Coding CPT defines maternity-related services as: 59400 Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care 59409 Vaginal delivery only (with or without episiotomy and/or forceps); 59410 Vaginal delivery only (with or without episiotomy and/or forceps ...
What is 59400?
What is the 59618 code?
What is the total obstetric package?
What is the CPT code for postpartum delivery?
What is the CPT code for OB?
What is a duplicate OB?
Can an E/M visit be reported with an OB ultrasound?
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What CPT code is 59400?
What are the documentation requirements for vaginal deliveries?CPT Codes for Vaginal Delivery59400Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy and/or forceps) and postpartum care59409Vaginal delivery only (with or without episiotomy and/or forceps);4 more rows
Does CPT code 59400 need a modifier?
Per ACOG coding guidelines, reporting of third- and fourth-degree lacerations should be identified by appending modifier 22 to the global OB code (CPT codes 59400 and 59610) or delivery only code (CPT codes 59409, 59410, 59612 and 59614).
What is included in the global obstetric Package?
The global obstetric package includes approximately 13 antepartum visits and traditionally extends to 6 weeks following delivery. The global obstetrical package procedure code includes antepartum, delivery and postpartum care.
How long is postpartum care for 59400?
Typical postpartum care ends after one or more outpatient visits up to six weeks following delivery. If you provide all of the client's prenatal care, perform the delivery, and provide the postpartum care, you must bill using the global OB procedure code.
What is included in a global maternity fee?
The global maternity allowance is a complete, one-time billing which includes all professional services for routine antepartum care, delivery services, and postpartum care. The fee is reimbursed for all of the member's obstetric care to one provider.
What services are included in postpartum care?
The comprehensive postpartum visit should include a full assessment of physical, social, and psychological well-being, including the following domains: mood and emotional well-being; infant care and feeding; sexuality, contraception, and birth spacing; sleep and fatigue; physical recovery from birth; chronic disease ...
What CPT codes are available for global OB care?
Global OB claims (CPT codes 59400, 59510, 59610 and 59618) must be billed in the “from-through” billing format (called “from-to” on the CMS-1500) with modifier AG (primary surgeon).
How do you code OB visits?
Code 59510 reports Routine OB care including antepartum care, cesarean delivery, and postpartum care.
What is the CPT code for global maternity?
CPT Code 59400 Includes Only Uncomplicated Services. It's important to note, global maternity billing covers services under normal, uncomplicated conditions.
Is contraceptive management included in postpartum care?
Contraceptive care includes screening, education, counseling, and provision of contraceptives (including in the immediate postpartum period). **** Contraceptive care also includes follow-up care (e.g., management, evaluation and changes, including the removal, continuation, and discontinuation of contraceptives).
What is the CPT code for Bakri balloon placement?
59899If curettage is performed to control postpartum uterine bleeding, then CPT code “59160 – curettage, postpartum” should be reported along with 59899 for placement of the tamponade balloon.
When do you use modifier 22?
Modifier 22 is defined as "Increased Procedural Services: When the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code.
What modifier is used for interpretation of a test result?
What you need to know. Modifier 26 is defined as the professional component (PC). The PC is outlined as a physician's service, which may include technician supervision, interpretation of results and a written report. Use modifier 26 when a physician interprets but does not perform the test.
Does CPT code 59514 need a modifier?
Only a non-global cesarean section delivery code (CPT codes 59514 or 59620) is a reimbursable service when submitted with an appropriate assistant surgeon modifier.
What is the correct CPT code for vaginal delivery?
included in the Global CPT codes of 59400 (Vaginal delivery) or 59510 (Cesarean delivery). the Global CPT codes of 59400 (Vaginal delivery) or 59510 (Cesarean delivery).
What is 59400?
59400 – Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care
What is the 59618 code?
59618 – Routine obstetric care including antepartum care, cesarean delivery, and postpartum care , following attempted vaginal delivery after previous cesarean delivery Oxford reimburses for these global OB codes when all of the antepartum, delivery and postpartum care is provided by the Same Group Physician and/or Other Health Care Professional.
What is the total obstetric package?
As defined by the American Medical Association (AMA), “the total obstetric package includes the provision of antepartum care, delivery, and postpartum care.” When the Same Group Physician and/or Other Health Care Professional provides all components of the OB package, report the global OB package code.
What is the CPT code for postpartum delivery?
The other physician should report the postpartum care only code (CPT code 59430) .
What is the CPT code for OB?
Per CPT guidelines and the American Congress of Obstetricians and Gynecologists (ACOG), the following services are included in the Global OB package (CPT codes 59400, 59510, 59610, 59618) :
What is a duplicate OB?
Duplicate OB services are defined as any of the below listed CPT codes provided by the same or different physician on the same or different date of service. This follows the coding guidelines defined by the AMA. CPT codes for Global OB Care fall into one of three categories:
Can an E/M visit be reported with an OB ultrasound?
If the patient is having an OB ultrasound and an E/M visit on the same date of service, by the Same Individual Physician or Other Health Care Professional, per ACOG coding guidelines the E/M service may be reported in addition to the OB ultrasound if the visit is identified as distinct and separate from the ultrasound procedure. Per CPT guidelines, modifier 25 should be appended to the E/M service to identify the service as separate and distinct.
How many visits are required for 59426?
If seven or more visits are provided, report 59426 Antepartum care only; 7 or more visits.
What is a 99219-24?
99219-24 Initial observation care, per day, for the evaluation and management of a patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of moderate complexity.
What is the code for delivery only?
If a provider performs the delivery only, and provides no antepartum or postpartum care, code selection depends on the type of delivery:#N#59409 Vaginal delivery only (with or without episiotomy and/or forceps)#N#59514 Cesarean delivery only#N#59612 Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps)#N#59620 Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery#N#Because delivery only is performed, and the provider is not performing the entire global maternity package, any inpatient E/M visits related to the delivery are separately reported.#N#Example: A patient presents to the hospital at 39 weeks gestation in the early onset of labor. The patient delivers a fe-male infant vaginally with the help of her primary obstetrician/gynecologist (OB/GYN). The patient develops a third-degree vaginal laceration during the delivery that is repaired by the OB/GYN. In total, the patient’s OB/GYN performs 14 antepartum visits, the delivery, and all postpartum care.#N#To correctly report this scenario, the physician will report 59400-22 for the global maternity care. Repair of minor vaginal lacerations are included in the delivery, but extensive lacerations may be reported by appending modifier 22 to the global code. In this case, the patient developed a third-degree laceration, which is considered major.#N#If a provider assists the patient’s primary OB/GYN with the delivery, and is claiming no antepartum or postpartum care, report the appropriate delivery-only CPT® code and append modifier 80 Assistant surgeon.#N#Example: Dr. A is the patient’s primary OB/GYN. The patient presents to the hospital in labor. The delivery appears to be complicated. Dr. B, who is on call with the hospital, is called in to assist Dr. A. The patient delivers a health baby girl via VBAC. Because Dr. B only assisted with the delivery (she provided no antepartum care and Dr. A is providing all postpartum care), her services are reported with 59612-80.#N#If the provider performs the delivery and also plans to provide postpartum care (but he or she did not provide any ante-partum care), CPT® specifies the following codes, based on the type of delivery:#N#59410 Vaginal delivery only (with or without episiotomy and/or forceps); including postpartum care#N#59515 Cesarean delivery only; including postpartum care#N#59614 Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps); including postpartum care#N#59622 Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery; including postpartum care#N#Example: A patient delivers a male infant via cesarean. The patient does not have a primary OB/GYN and has had no antepartum care. The physician performs the cesarean and orders the patient to follow up in his office for postpartum care in two weeks, which the patient does. To correctly code this encounter, the physician reports 59515.
What is the average number of antepartum visits?
In most circumstances, the average number of antepartum visits for uncomplicated care is 13.
What is the global code for postpartum care?
If the provider is not claiming the global maternity package, and is providing postpartum care only, report 59430 Postpartum care only (separate procedure).
What is code 99217-24?
99217-24 Observation care discharge day management (This code is to be utilized by the physician to report all services provided to a patient on discharge from “observation status” if the discharge is on other than the initial date of “observation status.” #N#Remember: The global maternity package includes uncomplicated care. Because this patient was diagnosed with pre-term labor and admitted to observation, this is not uncomplicated care and, thus, it is separately reportable with the observation E/M codes. Modifier 24 is needed to indicate these encounters are unrelated to the global maternity package.#N#Dawson Ballard, Jr., CPC, CEMC, CCS-P, is a coder at Town Plaza OBGYN in Overland Park, Kan., and a member of the Overland Park local chapter.
Is antepartum care included in global OB package?
The following services usually occur during antepartum care, but are not inclusive to the global OB package, and may be reported separately:
What should be included in a facility delivery note?
When facility documentation guidelines do not exist, the delivery note should include patient-specific, medically or clinically relevant details such as. Maternal–fetal assessment prior to delivery. Labor details, eg, induction or augmentation, if any. Details of the procedure, indications, if any, for OVD. Maternal status after the delivery.
Do physicians have to follow facility documentation guidelines?
Physicians must follow facility documentation guidelines, if any, when documenting delivery notes for vaginal deliveries. Physicians must also ensure that CPT code description elements for the code (s) reported are documented as applicable. CPT codes for vaginal delivery are as follows:
What is 59400?
59400 – Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care
What is the 59618 code?
59618 – Routine obstetric care including antepartum care, cesarean delivery, and postpartum care , following attempted vaginal delivery after previous cesarean delivery Oxford reimburses for these global OB codes when all of the antepartum, delivery and postpartum care is provided by the Same Group Physician and/or Other Health Care Professional.
What is the total obstetric package?
As defined by the American Medical Association (AMA), “the total obstetric package includes the provision of antepartum care, delivery, and postpartum care.” When the Same Group Physician and/or Other Health Care Professional provides all components of the OB package, report the global OB package code.
What is the CPT code for postpartum delivery?
The other physician should report the postpartum care only code (CPT code 59430) .
What is the CPT code for OB?
Per CPT guidelines and the American Congress of Obstetricians and Gynecologists (ACOG), the following services are included in the Global OB package (CPT codes 59400, 59510, 59610, 59618) :
What is a duplicate OB?
Duplicate OB services are defined as any of the below listed CPT codes provided by the same or different physician on the same or different date of service. This follows the coding guidelines defined by the AMA. CPT codes for Global OB Care fall into one of three categories:
Can an E/M visit be reported with an OB ultrasound?
If the patient is having an OB ultrasound and an E/M visit on the same date of service, by the Same Individual Physician or Other Health Care Professional, per ACOG coding guidelines the E/M service may be reported in addition to the OB ultrasound if the visit is identified as distinct and separate from the ultrasound procedure. Per CPT guidelines, modifier 25 should be appended to the E/M service to identify the service as separate and distinct.
