Wiki Antepartum, Delivery, and Postpartum Coding

[ShannonH89]

If the Antepartum and delivery were done but not the postpartum care then do you have to code the antepartum and delivery out separately? Do you end up waiting the 6 week postpartum period to bill out the antepartum and delivery then in order to know whether to code and bill with the group code of either 59400 or 59510 (depending on delivery type) or to code and bill it out separately without the postpartum care? Thank you!!

 

[sujaya101]

If the Antepartum and delivery were done but not the postpartum care then do you have to code the antepartum and delivery out separately? Do you end up waiting the 6 week postpartum period to bill out the antepartum and delivery then in order to know whether to code and bill with the group code of either 59400 or 59510 (depending on delivery type) or to code and bill it out separately without the postpartum care? Thank you!!

There is not a comprehensive CPT code that describes antepartum care including delivery. Therefore, when antepartum care and delivery are performed, the provider must bill the appropriate antepartum code in addition to the appropriate delivery code.
• <3 antepartum visits are performed – bill appropriate E/M codes for the visits
• 4-6 antepartum visits – Bill 59425
• 7-14 antepartum visits – Bill 59426

Vaginal delivery only – bill 59409
• C-section delivery only – bill 59514
• VBAC delivery only – bill 59612
• C-section after attempted VBAC delivery only – bill 59620

You do not have to wait 6 weeks to bill above.

 

[ShannonH89]

Thank you!

Thank you for this!! I have found that per the insurances I am to code out and bill the global delivery code at the time of delivery and that if they do not show for their postpartum visit within the 6 weeks then it is still ok to leave it as the global delivery code.

 

[lmccoy12]

lmccoy12

How would you code the antepartum care (4-6 visits) and postpartum care only if patient delivered out of state? Our antepartum care code 59425 was denied by insurance as global. I also think we should be able to bill the postpartum care as patient came back to our practice for this care using CPT Code 59430. Has anyone experienced this scenario?
Thank you in advance for your input!