2025 CPT code 59622

Repeat Cesarean Delivery after failed Vaginal Birth Attempt following prior Cesarean.

Adhere to the most up-to-date CPT coding guidelines, focusing on the specific criteria for choosing among codes 59610-59622 based on the circumstances surrounding the VBAC attempt and the eventual delivery method.

Modifiers, such as modifier 22 (increased procedural service) may be appropriate if the circumstances significantly increase the work performed beyond the usual Cesarean delivery, necessitating detailed documentation to support the modifier use.Modifier 59 (distinct procedural service) may be used if there are multiple distinct procedures that are separately reported.

Medical necessity for a repeat Cesarean delivery after a failed VBAC attempt is determined based on clinical indications such as fetal distress, maternal exhaustion, or cephalopelvic disproportion. Documentation should clearly justify the need for the intervention, demonstrating that the risks of continuing labor outweigh the benefits of a VBAC attempt.

The clinical responsibility includes antepartum care (if applicable), intrapartum care (labor management and delivery), and postpartum care.The physician's duties encompass managing labor, performing the Cesarean delivery, managing potential complications, providing postpartum wound care and patient education.

IMPORTANT Codes 59610-59621 represent other scenarios within Delivery Procedures After Previous Cesarean Delivery, with variations in the complexity and success of the VBAC attempt.Code 59510, 59514, or 59515 are used for elective Cesarean deliveries.

In simple words: This code covers the entire process of a second Cesarean birth after a woman has previously had a Cesarean and attempts a vaginal delivery that is unsuccessful. It includes the hospital stay, the surgery, and follow-up care.

This CPT code encompasses the global service of a repeat Cesarean delivery following a failed attempt at a vaginal birth after a previous Cesarean section (VBAC).The service includes inpatient admission, intensive labor management, Cesarean delivery of the fetus and placenta via abdominal incision, and both inpatient and outpatient postpartum care.The global period typically covers routine inpatient care and one or more outpatient postpartum visits up to six weeks post-delivery. This code is used when a VBAC attempt is unsuccessful, necessitating a repeat Cesarean section.

Example 1: A 39-year-old woman with a prior Cesarean birth attempts a VBAC.After several hours of labor, fetal distress necessitates an emergency Cesarean section. Code 59622 is used., A 35-year-old woman attempts a VBAC but progresses to a prolonged labor without descent of the fetal head.After evaluation, a repeat Cesarean is performed. Code 59622 is used., A 40-year-old woman with a prior Cesarean birth elects for a trial of labor. However, at 6cm dilation, cephalopelvic disproportion becomes apparent, requiring a Cesarean delivery. Code 59622 is used.

Detailed documentation should include the history of previous Cesarean delivery, reasons for attempting VBAC, labor course (including monitoring data such as fetal heart rate and uterine contractions),reason for Cesarean decision, operative notes (incision type, intraoperative findings, estimated blood loss),postoperative course, and postpartum care provided.

** Always refer to the most current CPT codebook and payer-specific guidelines for accurate coding and reimbursement.

  • Revenue Code: P1G (Major Procedure - Other)
  • RVU: This information is not available in the provided text.RVUs vary based on geographic location and other factors. Consult the CMS website or a local fee schedule for current values.
  • Global Days : The global period for this code includes inpatient and outpatient care for up to six weeks post-delivery.Specific details about the global surgical period (0, 10, or 90 days) are not explicitly stated, and would need to be determined based on payer-specific guidelines.
  • Payment Status: Active
  • Modifier TC rule: No information is available in the provided text about TC modifier application.
  • Fee Schedule : Historical fee schedule data is not available. Contact your payer or use a fee schedule database for historical fee data.
  • Specialties:Obstetrics and Gynecology
  • Place of Service:Inpatient Hospital, Ambulatory Surgical Center
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