How To Use CPT Code 59614

CPT 59614 describes the procedure for vaginal delivery after a previous cesarean delivery, including postpartum care. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 59614?

CPT 59614 can be used to describe the procedure for vaginal delivery after a previous cesarean delivery, including postpartum care. This code is used when the provider admits the patient to the hospital for delivery and provides intensive labor management, including fetal monitoring, use of low forceps, and episiotomy. The provider performs the vaginal delivery of the fetus and placenta and provides inpatient and outpatient postpartum care. This code is used when the patient has had a previous cesarean delivery but is able to deliver vaginally at this delivery.

2. Official Description

The official description of CPT code 59614 is: ‘Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps); including postpartum care.’

3. Procedure

1. The provider admits the patient to the hospital for delivery and provides intensive labor management, including fetal monitoring, use of low forceps, and episiotomy.
2. The provider performs the vaginal delivery of the fetus and placenta.
3. The provider provides inpatient and outpatient postpartum care, which may include monitoring vital signs, pain management, patient diet, and ambulation.
4. The provider visits the patient several hours after delivery to check on her progress and follows up with additional visits until the day of discharge.
5. The provider performs a physical examination at the outpatient postpartum visit to ensure that the mother is recovering normally.
6. The provider discusses care of the breasts and vulva, diet, exercise, and birth control options with the patient.
7. The provider may perform a screening Pap smear specimen if necessary.

4. Qualifying circumstances

Patients eligible for CPT 59614 are those who have had a previous cesarean delivery but are able to deliver vaginally at this delivery. The provider must provide intensive labor management, including fetal monitoring, use of low forceps, and episiotomy. The provider must also provide inpatient and outpatient postpartum care, including monitoring vital signs, pain management, patient diet, and ambulation. The patient may have one or more outpatient visits up to six weeks following delivery.

5. When to use CPT code 59614

CPT code 59614 should be used when the patient has had a previous cesarean delivery but is able to deliver vaginally at this delivery. It is appropriate to bill this code when the provider performs the vaginal delivery of the fetus and placenta and provides inpatient and outpatient postpartum care. This code should not be used for cesarean deliveries or for vaginal deliveries without a previous cesarean delivery.

6. Documentation requirements

To support a claim for CPT 59614, the provider must document the following information:

• Previous cesarean delivery
• Details of the labor management, including fetal monitoring, use of low forceps, and episiotomy
• Date and time of the vaginal delivery
• Details of the postpartum care, including monitoring vital signs, pain management, patient diet, and ambulation
• Details of the outpatient postpartum visits, including physical examination, discussion of care, and any necessary procedures
• Signature of the provider

7. Billing guidelines

When billing for CPT 59614, ensure that the patient has had a previous cesarean delivery but is able to deliver vaginally at this delivery. Use this code for vaginal deliveries only, not for cesarean deliveries. Add modifier 22, Increased procedural service, if the provider’s work is greater than normal. Do not report CPT 59614 with other codes for delivery procedures after previous cesarean delivery (59610-59622).

8. Historical information

CPT 59614 was added to the Current Procedural Terminology system on January 1, 1996. There have been no updates to the code since its addition.

9. Examples

1. A patient who had a previous cesarean delivery is able to deliver vaginally at this delivery. The provider admits the patient to the hospital, provides intensive labor management, performs the vaginal delivery of the fetus and placenta, and provides inpatient and outpatient postpartum care.
2. A patient who had a previous cesarean delivery is able to deliver vaginally at this delivery. The provider admits the patient to the hospital, provides intensive labor management, performs the vaginal delivery of the fetus and placenta using low forceps, and provides inpatient and outpatient postpartum care.
3. A patient who had a previous cesarean delivery is able to deliver vaginally at this delivery. The provider admits the patient to the hospital, provides intensive labor management, performs the vaginal delivery of the fetus and placenta with an episiotomy, and provides inpatient and outpatient postpartum care.
4. A patient who had a previous cesarean delivery is able to deliver vaginally at this delivery. The provider admits the patient to the hospital, provides intensive labor management, performs the vaginal delivery of the fetus and placenta using low forceps and with an episiotomy, and provides inpatient and outpatient postpartum care.
5. A patient who had a previous cesarean delivery is able to deliver vaginally at this delivery. The provider admits the patient to the hospital, provides intensive labor management, performs the vaginal delivery of the fetus and placenta using low forceps and with an episiotomy, and provides inpatient and outpatient postpartum care, including monitoring vital signs, pain management, patient diet, and ambulation.