2025 CPT code 59400
Effective Date: N/A Surgery - Surgical Procedures for Maternity Care and Delivery Feed
Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care.
Modifiers may be applicable in certain circumstances, such as reduced services (modifier 52) or increased procedural services (modifier 22).
Medical necessity for this code requires a confirmed pregnancy and the provision of routine obstetrical care, including antepartum, delivery, and postpartum services.
The physician is responsible for the complete care of the pregnant person, from initial prenatal visits through labor and delivery, and postpartum care.
In simple words: This package covers all the care a pregnant person receives from the beginning of their pregnancy until six weeks after a vaginal delivery. It includes regular checkups during pregnancy, care during labor and delivery (including assistance with tools like forceps or episiotomy if necessary), and follow-up care after the baby is born.
This global service includes all antepartum care, admission to the hospital for delivery, labor management (including induction, fetal monitoring, use of low forceps and episiotomy), vaginal delivery of the fetus and placenta, and inpatient and outpatient postpartum care. Typical global services begin at eight to ten weeks gestation, with a full-term vaginal delivery at thirty-nine to forty weeks gestation, and routine outpatient postpartum care for six weeks following delivery.
Example 1: A 30-year-old woman with an uncomplicated pregnancy receives routine prenatal care, delivers vaginally with an episiotomy, and receives routine postpartum care., A 25-year-old woman with a pregnancy complicated by gestational diabetes receives routine prenatal care with additional monitoring for her diabetes, delivers vaginally with forceps assistance, and receives routine postpartum care., A 35-year-old woman with a prior cesarean section elects for a vaginal delivery after cesarean (VBAC). She receives routine prenatal care and delivers vaginally without complications, followed by routine postpartum care.
Documentation should include all prenatal visit records, details of the delivery (including use of forceps or episiotomy), and postpartum care records. The medical record must support the medical necessity of all services provided.
- Revenue Code: P1G
- Global Days: Global period includes antepartum care, delivery, and postpartum care (inpatient and outpatient) for six weeks following delivery.
- Specialties:Obstetrics and Gynecology, Family Medicine, Midwifery
- Place of Service:Inpatient Hospital, Office, Outpatient Hospital