CPT Code 59515 Cesarean Delivery Including Postpartum Care Billing Guide

Overview

CPT Code 59515 describes the global maternity package for a cesarean delivery, including inpatient hospital admission, surgical delivery of the fetus and placenta via an abdominal incision, and inpatient plus outpatient postpartum care. Typical postpartum follow-up ends after one or more office visits within six weeks after delivery.

Purpose

This code ensures complete reimbursement for providers who perform cesarean deliveries and manage postpartum care when no antepartum services are billed under the same claim.

Clinical Scenarios Where CPT 59515 Applies

• The provider admits the patient for a planned or unplanned cesarean and provides postpartum follow-up visits.
• Cesarean delivery is performed for medical indications such as failure to progress, fetal distress, or placenta previa, followed by postpartum care.
• The patient transfers in for delivery only, but the same provider also provides postpartum care.

Procedure Overview for CPT 59515

• Inclusions: Hospital admission, cesarean delivery via abdominal incision, removal of placenta, immediate post-delivery inpatient care, and all postpartum visits up to six weeks.
• Exclusions: Antepartum care, repeat hospitalizations unrelated to delivery, or surgical complications managed outside the postpartum period.
• Documentation Requirements: Operative note for cesarean delivery, inpatient progress notes, postpartum follow-up visit notes, and discharge summary.

Billing and Reimbursement Tips for CPT 59515

• Bill once per pregnancy for cesarean delivery plus postpartum care.
• Do not bill antepartum codes unless those services were provided separately.
• Ensure operative and postpartum documentation is complete to prevent claim denials.
• If another provider handled postpartum care, bill CPT 59514 instead (delivery only).

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