CPT Code 59610 Routine Obstetric Care, Vaginal Delivery After Previous Cesarean (VBAC): Billing Guide

Overview

CPT 59610 refers to the global maternity package for a successful VBAC (vaginal birth after cesarean) that includes antepartum care, labor and delivery, and postpartum care. This code applies when the same provider manages the entire pregnancy through postpartum care following a prior cesarean section.

Purpose

Using CPT 59610 ensures full reimbursement for comprehensive maternal care in high-risk VBAC scenarios. It avoids splitting services into multiple claims and supports continuity of documentation throughout the maternity episode.

Clinical Scenarios Where 59610 Applies

1. The provider supervises the pregnancy, delivers vaginally after a previous cesarean, and provides postpartum follow-up.
2. Episiotomy or low-forceps delivery is performed during the VBAC.
3. Antepartum care begins in early pregnancy and continues with the same provider through delivery and routine postpartum visits.

Procedure Overview for 59610

• Inclusions: Comprehensive prenatal visits, hospital admission, labor support, fetal monitoring, episiotomy or forceps use, delivery of fetus and placenta, inpatient postpartum care, and outpatient visits up to six weeks after delivery.
• Exclusions: Antepartum-only, delivery-only, or postpartum-only care when provided separately, and any ultrasounds, lab work, or unrelated E/M services.
• Documentation Requirements: Record prior cesarean history, labor details including monitoring and interventions, hospital discharge date, and postpartum follow-up notes.

Billing and Reimbursement Tips for 59610

• Use CPT 59610 only if the same provider or group provides antepartum care, VBAC delivery, and postpartum services.
• Do not use this code if fewer than four prenatal visits occurred under your care; split component codes must be used instead.
• Do not separately bill routine postpartum or delivery codes with 59610.
• Bill unrelated E/M visits separately with appropriate ICD-10 codes and modifier 25.

Maximize VBAC Delivery Reimbursement with Proven Billing Strategies

VBAC deliveries are clinically rewarding but come with billing complexity that can cause underpayments if not managed correctly. CPT 59610 requires precise documentation for antepartum care, vaginal delivery after cesarean, and postpartum services, all by the same provider or group. Missing even one compliance detail can cost practices thousands in lost revenue.

At BillingFreedom, we help healthcare practices turn VBAC coding challenges into revenue opportunities. Our results-driven approach to OBGYN medical billing services consistently delivers measurable gains:

• 15–20% higher reimbursement accuracy through proactive documentation reviews and code pairing audits.
• 20–25% faster payments by eliminating claim errors before submission and streamlining payer communication.
• Up to 30% reduction in denials by applying payer-specific VBAC billing rules and pre-edit checks.
• 97–99% first-pass acceptance rates for global maternity packages, even in high-risk cases.
• With our expertise, your VBAC claims are not only compliant but optimized for full payment, freeing your team to focus on delivering exceptional patient care while we protect your revenue cycle.

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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