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CPT Code 59400 | Routine Obstetric Care Including Antepartum Care

Use CPT 59400 for routine obstetric care throughout pregnancy, labor, and postpartum.

What Is CPT Code 59400?

CPT code 59400 refers to a comprehensive care package that includes routine obstetric care throughout pregnancy, labor, and postpartum.

The global service typically begins eight to ten weeks into the pregnancy, with a full-term vaginal delivery at 39-40 weeks and routine outpatient postpartum care for six weeks following delivery.

The care package is designed to ensure that the patient receives the necessary medical attention throughout the pregnancy and delivery and is supported in the postpartum period.

Description

The CPT book describes CPT code 59400 as: “Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care.”

Explanation

In this global service, the provider and other healthcare professionals are responsible for all aspects of a patient’s care during pregnancy, labor, and postpartum.

This includes providing antepartum care, admitting the patient to the hospital for delivery, managing the labor process, including inducing labor if necessary, monitoring the fetus, using low forceps and episiotomy as needed, delivering the fetus and placenta vaginally, and providing inpatient and outpatient postpartum care.

The global service typically begins eight to ten weeks into the pregnancy, with a full-term vaginal delivery at 39-40 weeks and routine outpatient postpartum care for six weeks following delivery.

This comprehensive care package is designed to ensure that the patient receives the necessary medical attention throughout the pregnancy and delivery process. It is supported in the postpartum period as they recover and adjust to their new role as a parent.

How To Use CPT 59400

If the provider performs less than the requirements for global care, append a modifier 52 to CPT 59400. This may include providing fewer than regular antepartum visits or being absent for labor management or the baby’s delivery.

Add modifier 22 to CPT code 59400 when the provider performs work greater than usual.

This may occur because the patient was seen many more times than typical in the antepartum period due to complications, or the labor-management or delivery was significantly more work than for routine care. The provider must provide detailed documentation to get additional reimbursement.

Resources

CPT Professional 2022

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