CPT^® 59426, Under Vaginal Delivery, Antepartum and Postpartum Care Procedures

The Current Procedural Terminology (CPT^®) code 59426 as maintained by American Medical Association, is a medical procedural code under the range - Vaginal Delivery, Antepartum and Postpartum Care Procedures.

Additional/Related Information

Tabs

Summary

This service is considered a mini global code for the provider who provides seven or more antepartum visits. This can happen when the patient transfers out of the practice prior to delivery or the pregnancy terminates prior to delivery. In some cases, the provider must use this code when he does not provide all of the antepartum care, but does perform the delivery with or without postpartum care because the patient transfers in from another practice and the payer does not allow the physician to report the global services code, such as 59400.

For clinical responsibility, terminology, tips and additional info
start codify free trial.

View any code changes for 2024 as well as historical information on code creation and revision.

Crosswalks

Tabs

Combat the #1 denial reason - mismatched CPT-ICD-9 codes - with top Medicare carrier and private payer accepted diagnoses for the chosen CPT® code.

View the CPT® code's corresponding procedural code and DRG. In a click, check the DRG's IPPS allowable, length of stay, and more. To plug inpatient facility revenue drains, subscribe to DRG Coder today.

Crosswalk to an anesthesia code and its base units, and calculate payments in a snap! Subscribe to Anesthesia Coder today.

View matching HCPCS Level II codes and their definitions.

Forum

Have a question about CPT Code 59426 ? Start a discussion here

I need help

[QUOTE="jebond123, post: 513871, member: 820469"] When billing [I]antepartum care only(59425 or 59426) [/I] due to late entry for care or insurance change, what do I do if the care spans two separate ... [ Read More ]

I need help

When billing [I]antepartum care only(59425 or 59426) [/I] due to late entry for care or insurance change, what do I do if the care spans two separate years? Most times, these claims process with no p... [ Read More ]

Unbundling OB Global Package

[QUOTE="tterrell, post: 505687, member: 713464"] We had a situation similar to this in our clinic recently and I had to separate out the visits before the OB waiting period was over and bill those ind... [ Read More ]

Unbundling OB Global Package

We had a situation similar to this in our clinic recently and I had to separate out the visits before the OB waiting period was over and bill those individually to the patient as self-pay charges. Onc... [ Read More ]

CARESOURCE OHIO

[QUOTE="Lb6731@hotmail.com, post: 505159, member: 500864"] Happy New Year! Having issues billing maternity care with Caresource Ohio. Sometimes they pay the global billing ( ex: 59425, 59409, 59430... [ Read More ]

CARESOURCE OHIO

Happy New Year! Having issues billing maternity care with Caresource Ohio. Sometimes they pay the global billing ( ex: 59425, 59409, 59430) and sometimes they will only pay the ante partum (59425 o... [ Read More ]

how do I bill antepartum care only for twins

[QUOTE="mesteiner, post: 505048, member: 32432"] Do I bill 59426 for each baby? or 59426-22 for twins [/QUOTE] No. You are billing for pregnancy care of the mother no matter how many are in there. I... [ Read More ]

how do I bill antepartum care only for twins

[QUOTE="bgrasson, post: 505043, member: 298926"] i would bill the 59425 or 59426 codes- 1-3 visits only would be E/M. [/QUOTE] Do I bill 59426 for each baby? or 59426-22 for twins... [ Read More ]

how do I bill antepartum care only for twins

i would bill the 59425 or 59426 codes- 1-3 visits only would be E/M.... [ Read More ]

New OB Visit & 59426

Here's a good starter AAPC article about global maternity billing: [URL unfurl="true"]https://www.aapc.com/blog/25857-from-antepartum-to-postpartum-get-the-cpt-ob-basics/[/URL] If on the initial visit... [ Read More ]

View All