2025 CPT code 59618
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures for Maternity Care and Delivery Surgery Feed
Comprehensive obstetric care encompassing antepartum care, cesarean delivery following a failed VBAC attempt, and postpartum care.
Modifiers may be applicable depending on the circumstances. For instance, modifier 22 (Increased procedural service) may be used if the provider's work substantially exceeds the usual service.Appropriate documentation justifying the use of modifiers is essential.
Medical necessity is established when a vaginal delivery attempt after a previous Cesarean section fails due to factors such as fetal distress, cephalopelvic disproportion, or maternal complications, and an emergency Cesarean section is necessary to ensure maternal and fetal safety.
The clinical responsibility encompasses antepartum care (prenatal visits and monitoring), intrapartum care (labor management and Cesarean delivery), and postpartum care (maternal recovery follow-up).
In simple words: This code covers all the care a pregnant woman receives, from early prenatal visits to after the baby is born via C-section, if a vaginal birth attempt after a previous C-section fails. This includes checkups, monitoring, the C-section surgery itself, and post-birth care.
This CPT code, 59618, represents the global package of services for routine obstetric care, including antepartum care, cesarean delivery after an unsuccessful attempt at vaginal birth after cesarean (VBAC), and postpartum care.Antepartum care includes prenatal visits, monitoring, and assessments. The intrapartum phase involves managing labor, culminating in a cesarean delivery when vaginal delivery is deemed unsafe. Postpartum care includes inpatient and outpatient follow-up visits for maternal recovery and well-being.
Example 1: A patient with a prior Cesarean delivery attempts a VBAC.Labor is induced, but fetal distress necessitates an emergency Cesarean section.Code 59618 is used., A patient with a prior Cesarean delivery attempts a VBAC.She progresses to active labor but fails to advance past a certain point, necessitating a Cesarean delivery. Code 59618 is utilized., A patient with a prior Cesarean delivery elects to try for a VBAC. After several hours of labor, it becomes clear that a vaginal delivery is impossible due to the patient's previous C-section. Code 59618 is used to capture the services provided.
Comprehensive documentation is crucial, including the patient's medical history, prenatal records highlighting the prior Cesarean delivery, records of the labor and delivery process, the reasons for the failed VBAC attempt, surgical notes from the Cesarean section, and postpartum records indicating the care provided.Medical necessity for the Cesarean section must be clearly documented.Any complications encountered during the process need to be detailed.
** This code encompasses a comprehensive range of services.Precise documentation is critical for accurate billing.Always refer to the most current payer guidelines and coding manuals for precise interpretation and application of this code.
- Revenue Code: P1G (MAJOR PROCEDURE - OTHER)
- RVU: This information requires access to a current Relative Value Unit (RVU) database specific to the payer and location.RVUs vary significantly based on geographic location and payer-specific adjustments.
- Global Days : The global period for this code includes antepartum care, intrapartum management, Cesarean delivery, and post-partum care. The exact length of the global period varies depending on payer policies and may include inpatient and outpatient services for several weeks after delivery.
- Payment Status: Active
- Modifier TC rule: A technical component (TC) modifier is not directly applicable to code 59618 as it represents a global package of services.
- Fee Schedule : Fee schedules vary significantly based on location, payer, and time. For historical fee data, refer to a payer-specific fee schedule database covering the relevant periods.
- Specialties:Obstetrics and Gynecology
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center