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.

Your financial tranquility is our priority!