How To Use CPT Code 59622

CPT 59622 describes the procedure for cesarean delivery following an attempted vaginal delivery after a previous cesarean delivery, including postpartum care. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 59622?

CPT 59622 can be used to describe the procedure for cesarean delivery following an attempted vaginal delivery after a previous cesarean delivery. This code is used when the provider performs an abdominal incision to deliver the fetus and placenta after the patient’s attempt at a vaginal delivery fails. It also includes postpartum care, both inpatient and outpatient, for a specified period of time following the delivery.

2. Official Description

The official description of CPT code 59622 is: ‘Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery; including postpartum care.’

3. Procedure

1. The provider admits the patient to the hospital for delivery and manages the labor process.
2. If the patient’s attempt at a vaginal delivery after a previous cesarean delivery fails, the provider takes the patient to the operating room for a cesarean delivery.
3. The provider makes an abdominal incision, exposes the lower uterine segment, and delivers the fetus and placenta.
4. The provider administers a drug to help the uterus contract, manually removes the placenta and membranes, and examines the uterine cavity.
5. The provider closes the uterine wall and the abdominal incision, and inspects and repairs any lacerations or tears.
6. After the delivery, the provider provides inpatient postpartum care, including monitoring vital signs, pain management, patient diet, and ambulation.
7. The provider also provides outpatient postpartum care, which includes ongoing evaluation of the mother’s physical and mental status, physical examination, discussion of lactation, nutrition, exercise, birth control options, immunizations, and collection of a screening Pap smear specimen if necessary.

4. Qualifying circumstances

CPT 59622 is used when the patient has previously undergone a cesarean delivery and attempts a vaginal delivery for the current pregnancy. If the attempt at a vaginal delivery fails, resulting in a repeat cesarean, this code is appropriate. The procedure includes both the cesarean delivery and the postpartum care provided by the provider.

5. When to use CPT code 59622

CPT code 59622 should be used when the provider performs a cesarean delivery following an attempted vaginal delivery after a previous cesarean delivery. It is important to note that this code should only be used when the patient’s attempt at a vaginal delivery fails and a cesarean delivery becomes necessary. If a vaginal delivery is successful, a different code should be used to describe the delivery procedure.

6. Documentation requirements

To support a claim for CPT 59622, the provider must document the following information:

• Previous cesarean delivery
• Attempted vaginal delivery
• Reason for the cesarean delivery
• Date and time of the cesarean delivery
• Details of the procedure, including any complications or additional procedures performed
• Postpartum care provided, including inpatient and outpatient visits
• Signature of the provider

7. Billing guidelines

When billing for CPT 59622, ensure that the procedure meets the criteria for this code, including the previous cesarean delivery and attempted vaginal delivery. It is important to use the appropriate modifier, such as modifier 22 for increased procedural service, if the provider’s work is greater than normal. This may require additional documentation to support the increased reimbursement. It is also important to follow any specific billing guidelines provided by the payer or coding guidelines.

8. Historical information

CPT 59622 was added to the Current Procedural Terminology system on January 1, 1996. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient with a history of previous cesarean delivery attempts a vaginal delivery but requires a repeat cesarean delivery due to failure to progress in labor. The provider performs the cesarean delivery and provides postpartum care.
2. A patient attempts a vaginal delivery after a previous cesarean delivery but experiences fetal distress, requiring a repeat cesarean delivery. The provider performs the cesarean delivery and provides postpartum care.
3. A patient with a previous cesarean delivery attempts a vaginal delivery but develops complications, necessitating a repeat cesarean delivery. The provider performs the cesarean delivery and provides postpartum care.
4. A patient attempts a vaginal delivery after a previous cesarean delivery but requires a repeat cesarean delivery due to failure to progress in labor. The provider performs the cesarean delivery and provides postpartum care.
5. A patient with a history of previous cesarean delivery attempts a vaginal delivery but experiences uterine rupture, requiring a repeat cesarean delivery. The provider performs the cesarean delivery and provides postpartum care.
6. A patient attempts a vaginal delivery after a previous cesarean delivery but develops complications, necessitating a repeat cesarean delivery. The provider performs the cesarean delivery and provides postpartum care.
7. A patient with a previous cesarean delivery attempts a vaginal delivery but requires a repeat cesarean delivery due to failure to progress in labor. The provider performs the cesarean delivery and provides postpartum care.
8. A patient attempts a vaginal delivery after a previous cesarean delivery but experiences fetal distress, requiring a repeat cesarean delivery. The provider performs the cesarean delivery and provides postpartum care.