Overview
CPT 59620 is used when a patient with a prior cesarean delivery attempts a vaginal birth, but it fails, and the provider performs a cesarean delivery only without antepartum or postpartum services. This delivery-only global code includes hospital admission, labor management, delivery of the fetus and placenta via abdominal incision, and immediate post-delivery care on the same date of service. It does not cover prenatal or postpartum.
Purpose
This code ensures providers are reimbursed specifically for cesarean delivery when VBAC isn't successful, without overlapping antepartum or postpartum billing. It's essential in split-care scenarios and prevents global bundle misuse.
Clinical Scenarios Where 59620 Applies
- A patient attempts VBAC, labor fails, and provider performs Cesarean only.
- Prenatal care was completed elsewhere or by another provider.
- Postpartum care will be handled separately by you or another provider.
Procedure Overview
- Inclusions: Hospital admission, labor management (if needed), surgical cesarean delivery (fetus and placenta via abdominal incision), and immediate inpatient care on the day of delivery.
- Exclusions: Prenatal visits and any postpartum services beyond the day of delivery.
Documentation Requirements
- Admission and operative note outlining the failed VBAC attempt and details of surgical delivery.
- Notation that no antepartum or postpartum visits were included.
- Fetal and placental delivery details and patient outcome.
Billing and Reimbursement Tips
- Bill once per pregnancy, only the delivery portion (59620) if antepartum or postpartum care is billed separately or by another provider.
- Ensure the documentation clearly states that the VBAC attempt failed and only vaginal delivery was handled.
- Understand payer policies to avoid global care denials. 59620 must not be billed if the same provider provides antepartum or postpartum care.
BillingFreedom: Driving Revenue Precision for CPT 59620 Cases
When a VBAC attempt fails and you step in only for the cesarean delivery, your work deserves full, clean, and compliant reimbursement. However, with delivery-only codes like CPT 59620, even the smallest documentation gap or coding error can result in thousands of dollars in costs and create compliance risks.
At BillingFreedom, we specialize in high-complexity OBGYN billing, ensuring delivery-only cases are coded, paired, and submitted with precision. Our OBGYN medical billing services are built to protect every dollar you earn:
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Related ICD-10-CM Codes
ICD-10-CM Codes
O09.522 - Supervision of elderly multigravida, second trimester
O09.93 - Supervision of high risk pregnancy, unspecified, third trimester
O20.0 - Threatened abortion
O22.43 - Hemorrhoids in pregnancy, third trimester
O22.8X2 - Other venous complications in pregnancy, second trimester
O24.435 - Gestational diabetes mellitus in puerperium, controlled by oral hypoglycemic drugs
O30.003 - Twin pregnancy, unspecified number of placenta and unspecified number of amniotic sacs, third trimester
O32.9XX3 - Maternal care for malpresentation of fetus, unspecified, fetus 3
O33.6XX0 - Maternal care for disproportion due to hydrocephalic fetus, not applicable or unspecified
O33.9 - Maternal care for disproportion, unspecified
O34.00 - Maternal care for unspecified congenital malformation of uterus, unspecified trimester
O35.8XX0 - Maternal care for other (suspected) fetal abnormality and damage, not applicable or unspecified
O36.8220 - Fetal anemia and thrombocytopenia, second trimester, not applicable or unspecified
O41.8X30 - Other specified disorders of amniotic fluid and membranes, third trimester, not applicable or unspecified
O42.00 - Premature rupture of membranes, onset of labor within 24 hours of rupture, unspecified weeks of gestation
O44.53 - Low lying placenta with hemorrhage, third trimester
O45.8X2 - Other premature separation of placenta, second trimester
O60.23X9 - Term delivery with preterm labor, third trimester, other fetus
O61.0 - Failed medical induction of labor
O64.9XX9 - Obstructed labor due to malposition and malpresentation, unspecified, other fetus
O65.0 - Obstructed labor due to deformed pelvis
O66.9 - Obstructed labor, unspecified
O68 - Labor and delivery complicated by abnormality of fetal acid-base balance
O69.0XX0 - Labor and delivery complicated by prolapse of cord, not applicable or unspecified
O73.1 - Retained portions of placenta and membranes, without hemorrhage
O75.5 - Delayed delivery after artificial rupture of membranes
O76 - Abnormality in fetal heart rate and rhythm complicating labor and delivery
O77.0 - Labor and delivery complicated by meconium in amniotic fluid
O82 - Encounter for cesarean delivery without indication
O87.2 - Hemorrhoids in the puerperium
O92.29 - Other disorders of breast associated with pregnancy and the puerperium
O98.42 - Viral hepatitis complicating childbirth
O99.892 - Other specified diseases and conditions complicating childbirth
Z33.1 - Pregnant state, incidental
Z33.3 - Pregnant state, gestational carrier
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
Z37.9 - Outcome of delivery, unspecified
Z39.2 - Encounter for routine postpartum follow-up
Related CPT Codes
CPT Codes
59425 - Vaginal Delivery with Postpartum Care
59400 - Routine Obstetric Care. Vaginal Delivery, Antepartum and Postpartum Care Procedures
59150 - Laparoscopic Treatment of Ectopic Pregnancy
59030 - Fetal Scalp Blood Sampling
59610 - Routine Obstetric Care, Vaginal Delivery After Previous Cesarean (VBAC)