CPT Code 59525 Hysterectomy After Cesarean (Add-On)

Code description

CPT 59525 is an add-on code for a subtotal or total obstetric hysterectomy performed immediately after a cesarean delivery, usually through the same incision. Report it in addition to the primary cesarean code; it cannot be billed alone. Common clinical drivers include placenta accreta spectrum, uncontrollable hemorrhage/atony, uterine rupture, or morbidly adherent placenta.

Purpose

This code captures the significant extra work and risk beyond the cesarean itself, so you aren’t underpaid when an emergent obstetric hysterectomy is required during the same operative session. It’s listed separately, in addition to the primary procedure per CPT add-on rules.

Clinical Scenarios Where 59525 Is Applicable

• Emergent hysterectomy for placenta accreta spectrum identified intraoperatively at C-section.
• Uterine atony/hemorrhage unresponsive to conservative measures, requiring hysterectomy during C-section.
• Uterine rupture at C-section necessitating hysterectomy in the same session.

Procedure Overview for 59525

• What it captures: Subtotal (supracervical) or total hysterectomy performed immediately after cesarean delivery; typically via the same abdominal/uterine incision.
• What it excludes: The cesarean delivery itself (bill separately), antepartum care, and unrelated procedures (report separately when appropriate per payer policy).
• Primary code pairing: Report in addition to the appropriate cesarean code (e.g., 59514 cesarean delivery only, or 59515 cesarean delivery including postpartum care).

Setting

Inpatient hospital operating room during the cesarean delivery (same operative session), with immediate postpartum management as clinically indicated.

Documentation Requirements for 59525

• Indication for obstetric hysterectomy (e.g., accreta spectrum, atony with hemorrhage, rupture).
• Type: subtotal vs total hysterectomy; approach/technique noted.
• Timing/relationship to cesarean (same session; same incision).
• Attempts at conservative management (e.g., uterotonics, B-Lynch, ligations) when applicable.
• Operative note linking hysterectomy to the C-section and identifying the primary cesarean code reported.

Billing and Reimbursement Tips for 59525

• Add-on only: Do not report 59525 by itself; it must be listed in addition to the primary cesarean code. Add-on codes are exempt from the multiple-procedure reduction and are identified by phrases such as “List separately in addition to primary procedure.”
• Choose the correct primary:
  • 59514 If you performed delivery only.
  • 59515, if you also provide postpartum care.
• Modifiers: Avoid -51 on add-ons; use co-surgeon/assistant modifiers only when supported and allowed by payer edits.
• Frequency/limits: Some payers (e.g., state Medicaid programs) impose frequency limits (for example, “once in a lifetime” for total obstetric hysterectomy). Always verify plan rules.
• If different surgeons perform the C-section and hysterectomy, 59525 is still appropriate for the surgeon who conducts the hysterectomy during the same session, listed with the appropriate primary cesarean code context.

Maximize Post-Cesarean Hysterectomy Payments with BillingFreedom

Obstetric hysterectomy during C-section is rare, high-stakes, and tightly audited. At BillingFreedom, we structure your claim so the primary cesarean and 59525 add-on tell a clear clinical story, meeting payer edit logic the first time.

What we focus on (and the impact practices typically see):

• Cleaner coding = higher accuracy: Correct add-on pairing and documentation checklists routinely lift reimbursement accuracy by 15–20% on complex deliveries.
• Faster cash: Targeted pre-submission audits help reduce AR days by 15–25% by preventing avoidable pend/return cycles.
• Fewer denials: Payer-specific rules and NCCI edit checks cut denial rates by up to 30% for surgical maternity claims.
• Stronger first-pass acceptance: Clear operative linking (C-section → same-session hysterectomy) supports 97–99% clean-claim acceptance across major payers.

With our OBGYN medical billing services, we manage code pairing, modifier strategy, operative note abstraction, and payer-specific edits, allowing your team to focus on patient care while we protect your revenue.

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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