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Posted By Robin Frankland on 07-29-2019, 13:56:55 in Ob-Gyn
Hi Melanie,
I have a team of 14 OB/GYN coders to which I perform monthly coding education. This last session they wanted to know the proper use of 59430 (Postpartum care only). Per the CPT Maternity Care and Delivery guidelines "Postpartum care only services (59430) includes office or other outpatient visits following vaginal or cesarean section delivery. If all or part of the antepartum and/or postpartum patient care is provided except delivery due to termination of pregnancy by abortion or referral to another physician or other qualified health care professional for delivery, see the antepartum and postpartum care codes 59425, 59426 and 59430." My questions is two part, 1) Is 59430 only used for "routine postpartum care" i.e. uncomplicated? and 2) is 59430 only applicable in the circumstance of delivery due to termination of pregnancy by abortion or referral to another physician? My high risk patient (sickle cell crisis flare at 37 0/7 weeks gestation, late to care at 36 0/7 weeks gestation, & previous c/s delivery) delivered emergently at home a 37 4/7 weeks IUFD. Placenta was delivered spontaneously 1 1/2 hours following home delivery in an inpatient status and we provided inpatient after care (6/30-7/2). I look forward to your recommendations. Robin
Comments (2)
Posted By Robin Frankland on 07-29-2019, 18:18:12
Thank you Melanie.
Posted By Melanie Witt on 07-29-2019, 15:54:47
Yes, 59840 is only intended for routine PP care. That care may involve 1 or more visits depending on the delivery (cesarean usually involves 2 PP visits, while vaginal generally only 1 at 6-12 weeks). It is used only for outpatient visits so 1) the patient could have been delivered by another provider (not in your practice and not contracted with you), but you would not use this code after a termination of pregnancy before 20 completed weeks - abortion/miscarriage coding is different than delivery coding. In the situation you listed above, you have 2 options: delivery global code with a modifier -52 and submit documentation outlining how much of the work you did not do, or itemize. In that case bill the antepartum visits, then the hospital admission and hospital visits (if she delivered the placenta sponanteously, you would not bill for delivery of placenta). Then you can bill 59430 for the PP care that is routine.
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