Code Description:
CPT code 59614 is used to bill for comprehensive obstetric care involving vaginal delivery after a previous cesarean section (VBAC). This bundled code includes antepartum care, labor and delivery services, vaginal birth after cesarean, and postpartum care immediately following delivery. It covers all necessary prenatal visits, delivery procedures, and postpartum monitoring associated with VBAC.
Purpose:
The purpose of CPT 59614 is to ensure accurate billing for the full spectrum of care provided when a vaginal birth is achieved following a prior cesarean delivery. This code supports the documentation and reimbursement of specialized management and monitoring required for VBAC cases, promoting safe delivery and maternal recovery.
Clinical Scenarios Where CPT 59614 is Applicable
- Patients undergoing trial of labor after cesarean (TOLAC) resulting in successful vaginal delivery.
- Full-term pregnancies with a history of cesarean section but no contraindications to vaginal delivery.
- Cases requiring antepartum counseling and monitoring specific to VBAC.
- Delivery and postpartum care are performed in hospital or birthing center settings.
Procedure Overview
- Antepartum care focused on evaluating VBAC eligibility and monitoring pregnancy.
- Labor management aimed at safely achieving vaginal delivery post-cesarean.
- Delivery of the infant through vaginal birth after cesarean.
- Delivery of placenta and provision of postpartum care, including maternal and newborn monitoring.
Documentation Requirements For Vaginal Delivery After Previous Cesarean Delivery
- Complete antepartum records, including counseling on TOLAC risks and benefits, with patient consent.
- Detailed labor and delivery notes specifying timing, interventions, and successful vaginal birth after cesarean.
- Postpartum documentation reflecting maternal and newborn status and any complications.
- Clear evidence of prior cesarean and clinical decision-making supporting VBAC.
Billing and Reimbursement Tips For CPT 59614
- CPT 59614 bundles antepartum care, vaginal delivery after cesarean, and postpartum care into one comprehensive payment.
- Common modifiers include:
- Modifier 22 for increased procedural services due to complexity.
- Modifier 51 for multiple procedures during delivery.
- Modifier 52 for reduced services if the full scope is not performed.
- Verify specific payer policies on VBAC billing and bundled services.
- Ensure thorough and accurate documentation to avoid claim denials.
Medicare Coverage and Reimbursement for CPT Code 59614
Medicare coverage for CPT 59614 is generally limited since obstetric services typically serve younger populations not covered by traditional Medicare. Some Medicare Advantage plans may provide coverage in certain circumstances.
Local Medicare Administrative Contractors (MACs) define regional coverage and documentation guidelines. Providers should consult their MAC for specific reimbursement policies related to VBAC delivery.
Reimbursement is based on the Medicare Physician Fee Schedule and varies by region and type of provider. Coordination with Medicaid or private insurers may be necessary due to Medicare’s limited obstetric coverage.
Why Choose BillingFreedom for Your VBAC Delivery Billing?
At BillingFreedom, we combine clinical expertise with expert billing to ensure your vaginal deliveries after cesarean (VBAC) are accurately coded and reimbursed. Our certified professionals work closely with your care team to:
- Reduce denials related to VBAC documentation by up to 30%.
- Maximize revenue with compliant and thorough coding for CPT 59614.
- Expedite claim submissions and increase payment speed by 20-40%.
- Navigate complex payer policies with confidence.
Partner with BillingFreedom for expert OBGYN medical billing services focused on CPT 59614, so you can focus on patient care while we optimize 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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Related ICD-10-CM Codes
ICD-10-CM Codes
O09.893 - Supervision of other high risk pregnancies, third trimester
O09.899 - Supervision of other high risk pregnancies, unspecified trimester
O10.012 - Pre-existing essential hypertension complicating pregnancy, second trimester
O10.013 - Pre-existing essential hypertension complicating pregnancy, third trimester
O10.02 - Pre-existing essential hypertension complicating childbirth
O15.03 - Eclampsia complicating pregnancy, third trimester
O15.1 - Eclampsia complicating labor
O16.2 - Unspecified maternal hypertension, second trimester
O16.3 - Unspecified maternal hypertension, third trimester
O16.4 - Unspecified maternal hypertension, complicating childbirth
O60.20X0 - Term delivery with preterm labor, unspecified trimester, not applicable or unspecified
O60.20X1 - Term delivery with preterm labor, unspecified trimester, fetus 1
O60.20X2 - Term delivery with preterm labor, unspecified trimester, fetus 2
O60.20X3 - Term delivery with preterm labor, unspecified trimester, fetus 3
O60.20X4 - Term delivery with preterm labor, unspecified trimester, fetus 4
O99.892 - Other specified diseases and conditions complicating childbirth
O99.893 - Other specified diseases and conditions complicating puerperium
Z03.71 - Encounter for suspected problem with amniotic cavity and membrane ruled out
Z34.80 - Encounter for supervision of other normal pregnancy, unspecified trimester
Z34.90 - Encounter for supervision of normal pregnancy, unspecified, unspecified trimester
Z37.0 - Single live birth
Z37.1 - Single stillbirth
Z37.2 - Twins, both liveborn
Z37.3 - Twins, one liveborn and one stillborn
Z37.4 - Twins, both stillborn
Z37.59 - Other multiple births, all liveborn
Z37.69 - Other multiple births, some liveborn
Z37.7 - Other multiple births, all stillborn
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