2025 CPT code 59425

Antepartum care only; 4-6 visits.

Do not report 59425 if less than four or more than six antepartum visits are provided. Do not use this code in conjunction with global maternity care packages (59400-59622) if the same provider performed all antepartum care.

Medical necessity for this code is established by the standard of care for routine antepartum visits during pregnancy.

The provider is responsible for monitoring the mother's and fetus's health, estimating gestational age, identifying risk factors, providing education and counseling, and performing necessary examinations and tests throughout the antepartum period.

IMPORTANT For 1-3 antepartum visits, use E/M codes (e.g., 99202-99215). For 7 or more visits, use 59426. For global maternity care packages, see 59400-59622.

In simple words: This code covers the doctor's visits during pregnancy, including check-ups, tests, and monitoring of both the mother and baby's health, for 4 to 6 visits before delivery.

This code encompasses antepartum care including the initial and subsequent history and physical examinations, routine chemical urinalysis, recording of weight, blood pressures, and fetal heart tones, as well as the regular visits during pregnancy (monthly up to 28 weeks, biweekly to 36 weeks, and weekly until delivery). It is used when a provider performs 4-6 visits.

Example 1: A pregnant woman transfers to a new physician's care at 20 weeks gestation and is seen for four antepartum visits before delivering. The new physician would report 59425 for the antepartum care., A patient has six antepartum visits with her physician before experiencing a pregnancy termination. The physician would bill 59425 for the antepartum care., A patient is seen four times for routine prenatal check-ups, including history, physical exams, and fetal heart tone monitoring, during the first two trimesters of her pregnancy.

Documentation should include details of each visit, such as date, history, physical exam findings (including weight, blood pressure, fetal heart tones), urinalysis results, and any other performed procedures. The documentation should clearly justify medical necessity for the services provided.

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