Overview
CPT 59430 is the code for postpartum care only, billed when a provider handles only the postpartum period (up to six weeks) following delivery without antepartum or delivery services. It applies when maternity care is split across providers or when global packages (e.g., 59400) are not utilized. Postpartum care may include multiple outpatient visits, even beyond the hospital discharge.
Purpose
This code ensures accurate payment for postpartum services rendered separately from delivery or prenatal care. It prevents denial or underpayment when care is split between providers or when the global OB package isn’t billed.
Clinical Scenarios Where 59430 Applies
- Postpartum follow-up when another provider performed antepartum and delivery.
- Delivery occurred elsewhere, but you manage postpartum care.
- Split-care arrangement where different clinicians or practices divide prenatal, delivery, and postpartum phases.
Procedure Overview for 59430
- Inclusions: Office or outpatient visits up to six weeks post-delivery (physical exam, lactation counseling, contraception, emotional support, immunizations).
- Exclusions: Antepartum or delivery services and any postpartum inpatient care unless bundled.
- Documentation Requirements: Include visit dates, postpartum assessments, counseling provided, and evidence of no earlier postpartum billing for global or delivery care.
Billing and Reimbursement Tips for 59430
- Bill only once per patient per postpartum period, regardless of the number of visits.
- Do not use this code if you billed GlobalCare OB; performed separately E/M codes for postpartum when separate.
- Use modifier 25 with E/M for unrelated diagnoses outside the postpartum scope.
- Confirm payer policies for telehealth use; some restrict 59430 to in-person visits.
Optimizing Reimbursement for Postpartum-Only Services with BillingFreedom
Accurate billing for postpartum-only care is essential for ensuring fair reimbursement while maintaining compliance with payer requirements.
Through our OBGYN medical billing services, we help practices eliminate revenue leakage and improve claim outcomes for CPT 59430.
Results our clients typically achieve:
- 15–20% improvement in payment accuracy through detailed documentation review and coding verification.
- 20–25% faster claims processing by reducing avoidable payer holds with pre-submission audits.
- Achieve up to 30% lower denial rates with targeted payer-specific coding strategies.
- 97–99% clean claim acceptance through accurate linkage to prior delivery records.
- Inclusion of all eligible postpartum-related services while avoiding duplicate billing with global packages.
- Consistent compliance with both payer policies and national coding guidelines to minimize audit risks.
With BillingFreedom managing postpartum-only billing, healthcare teams can dedicate their full attention to patient recovery, confident that claims are handled with precision and expertise.
For more details about our exceptional medical billing services, please don't hesitate to contact us via email at info@billingfreedom.com or call us at +1 (855) 415-3472.
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Related ICD-10-CM Codes
ICD-10-CM Codes
O34.218 - Maternal care for other type scar from previous cesarean delivery
O34.22 - Maternal care for cesarean scar defect (isthmocele)
O35.00X0 - Maternal care for (suspected) central nervous system malformation or damage in fetus, unspecified, not applicable or unspecified
O35.00X1 - Maternal care for (suspected) central nervous system malformation or damage in fetus, unspecified, fetus 1
O35.00X2 - Maternal care for (suspected) central nervous system malformation or damage in fetus, unspecified, fetus 2
O35.00X3 - Maternal care for (suspected) central nervous system malformation or damage in fetus, unspecified, fetus 3
O35.00X4 - Maternal care for (suspected) central nervous system malformation or damage in fetus, unspecified, fetus 4
O35.00X5 - Maternal care for (suspected) central nervous system malformation or damage in fetus, unspecified, fetus 5
O35.00X9 - Maternal care for (suspected) central nervous system malformation or damage in fetus, unspecified, other fetus
O35.01X0 - Maternal care for (suspected) central nervous system malformation or damage in fetus, agenesis of the corpus callosum, not applicable or unspecified
O35.01X1 - Maternal care for (suspected) central nervous system malformation or damage in fetus, agenesis of the corpus callosum, fetus 1
O35.01X2 - Maternal care for (suspected) central nervous system malformation or damage in fetus, agenesis of the corpus callosum, fetus 2
O35.01X3 - Maternal care for (suspected) central nervous system malformation or damage in fetus, agenesis of the corpus callosum, fetus 3
O35.01X4 - Maternal care for (suspected) central nervous system malformation or damage in fetus, agenesis of the corpus callosum, fetus 4
O35.01X5 - Maternal care for (suspected) central nervous system malformation or damage in fetus, agenesis of the corpus callosum, fetus 5
O35.01X9 - Maternal care for (suspected) central nervous system malformation or damage in fetus, agenesis of the corpus callosum, other fetus
O35.02X0 - Maternal care for (suspected) central nervous system malformation or damage in fetus, anencephaly, not applicable or unspecified
O35.02X1 - Maternal care for (suspected) central nervous system malformation or damage in fetus, anencephaly, fetus 1
O35.02X2 - Maternal care for (suspected) central nervous system malformation or damage in fetus, anencephaly, fetus 2
O35.02X3 - Maternal care for (suspected) central nervous system malformation or damage in fetus, anencephaly, fetus 3
O35.02X4 - Maternal care for (suspected) central nervous system malformation or damage in fetus, anencephaly, fetus 4
O35.02X5 - Maternal care for (suspected) central nervous system malformation or damage in fetus, anencephaly, fetus 5
O35.02X9 - Maternal care for (suspected) central nervous system malformation or damage in fetus, anencephaly, other fetus
O35.03X0 - Maternal care for (suspected) central nervous system malformation or damage in fetus, choroid plexus cysts, not applicable or unspecified
O35.03X1 - Maternal care for (suspected) central nervous system malformation or damage in fetus, choroid plexus cysts, fetus 1
O35.03X2 - Maternal care for (suspected) central nervous system malformation or damage in fetus, choroid plexus cysts, fetus 2
O35.03X3 - Maternal care for (suspected) central nervous system malformation or damage in fetus, choroid plexus cysts, fetus 3
O35.03X4 - Maternal care for (suspected) central nervous system malformation or damage in fetus, choroid plexus cysts, fetus 4
O35.03X5 - Maternal care for (suspected) central nervous system malformation or damage in fetus, choroid plexus cysts, fetus 5
O35.03X9 - Maternal care for (suspected) central nervous system malformation or damage in fetus, choroid plexus cysts, other fetus
O89.3 - Toxic reaction to local anesthesia during the puerperium
O89.4 - Spinal and epidural anesthesia-induced headache during the puerperium
O89.6 - Failed or difficult intubation for anesthesia during the puerperium
O92.02 - Retracted nipple associated with the puerperium
O92.12 - Cracked nipple associated with the puerperium
O99.893 - Other specified diseases and conditions complicating puerperium
Z39.0 - Encounter for care and examination of mother immediately after delivery
Z39.1 - Encounter for care and examination of lactating mother
Z39.2 - Encounter for routine postpartum follow-up
Related CPT Codes
CPT Codes
59425 - Vaginal Delivery with Postpartum Care
59400 - Routine Obstetric Care. Vaginal Delivery, Antepartum and Postpartum Care Procedures
59150 - Laparoscopic Treatment of Ectopic Pregnancy
59030 - Fetal Scalp Blood Sampling
59610 - Routine Obstetric Care, Vaginal Delivery After Previous Cesarean (VBAC)
59620 - Cesarean Delivery Only After Attempted VBAC (Delivery-Only Global)