CPT Code 59510: Routine Obstetric Care Including Antepartum Care, Cesarean delivery, and Postpartum Care

What is CPT code 59510?

The 59510 CPT code refers to routine obstetric care, including antepartum care, cesarean delivery, and postpartum care. It represents a global obstetrical package, bundling these maternity services into one comprehensive code for pregnancies that result in cesarean section delivery. This approach simplifies the billing process and supports accurate reimbursement when the same provider or same physician group delivers the full scope of care.

This code applies specifically to pregnancies in which the provider performs routine antepartum care, the cesarean delivery procedures themselves, and postpartum follow-up care throughout the postpartum period. These services are essential components of comprehensive obstetric care and are vital in supporting maternal and infant health outcomes.

The global nature of the 59510 CPT code means that all services performed during the maternity cycle are reported together, improving revenue cycle management for healthcare practices. However, this code should not be used if only part of the care—such as antepartum or postpartum care—is provided. In such cases, different CPT codes must accurately reflect the services provided.

Understanding how and when to use CPT code 59510 helps healthcare providers maintain compliance, support medical billing accuracy, and ensure accurate reimbursement for routine maternity care.

CPT code 59510 documentation requirements

Proper documentation is critical when billing for CPT code 59510, as it ensures clear communication of the services performed and supports compliance with billing guidelines. Here are the essentials:

Antepartum care documentation

• Detailed admission history and physical examination
• Record of prenatal care and all prenatal visits with dates, gestational age, and fetal heart tones
• Identification of complications or high-risk conditions such as diabetes, hypertension, or previous cesarean delivery
• Status and management of Group B Streptococcus (GBS)
• Notes on laboratory tests or laboratory services provided during pregnancy

Cesarean delivery documentation

• Operative report describing cesarean section delivery indications and procedure details
• Intraoperative findings, including any complications that arise or additional procedures
• Clear mention of whether an assistant surgeon was involved, if applicable
• Any use of modifier usage like Modifier 22 for increased procedural services if the delivery was unusually complex

Postpartum care documentation

• Summary of postpartum follow-up visits and maternal assessments
• Notes on infant evaluation and patient experience
• Counseling on recovery, breastfeeding, contraception, and postpartum health
• Documentation of the postpartum period and any complications managed

Thorough documentation ensures alignment with the billing process, supports proper coding and helps prevent reimbursement issues.

CPT code 59510 billing guidelines

Accurate billing for the 59510 CPT code requires a clear understanding of what it includes and when this code is appropriate. Here’s what to keep in mind:

Appropriate use

• Bill CPT code 59510 when the same provider delivers routine antepartum care, cesarean delivery procedures, and postpartum care.
• Do not use this code if the provider delivers only part of the care (e.g., just delivery services or postpartum care).

Key billing considerations

• Vaginal delivery services must be billed with separate codes, such as 59400.
• If a patient transfers care mid-pregnancy, each qualified health care professional bills for only the services provided.
• Additional services, like tubal ligation during cesarean section, require separate procedure codes.
• When complications arise and require more work than typical, use Modifier 22 to indicate increased procedural services.

Common billing scenarios

• For full-scope maternity services with cesarean delivery, bill 59510 CPT code.
• For cesarean delivery only without antepartum/postpartum, use 59514.
• For delivery and postpartum care without antepartum, use 59515.

Following these billing guidelines helps healthcare practices achieve accurate reimbursement and maintain efficient revenue cycle operations.

Other related codes

When routine maternity care is not provided in full or when different delivery scenarios occur, alternative CPT codes should be selected to reflect the exact services performed. Here’s a comparison of routine obstetric care codes, including vaginal delivery, cesarean section, and partial maternity care.

• 59400 – Routine obstetric care, including antepartum care, vaginal delivery, and postpartum care.
• 59409 – Vaginal delivery only (with or without episiotomy and/or forceps).
• 59410 – Vaginal delivery only, including postpartum care.
• 59425 – Antepartum care only; 4-6 visits.
• 59426 – Antepartum care only; 7 or more visits.
• 59430 – Postpartum care only (separate procedure).
• 59514 – Cesarean delivery only.
• 59515 – Cesarean delivery only, including postpartum care.
• 59610 – Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy and/or forceps), and postpartum care, after previous cesarean delivery.
• 59612 – Vaginal delivery only, after previous cesarean (with or without episiotomy and/or forceps).
• 59614 – Vaginal delivery only, after previous cesarean, including postpartum care.
• 59618 – Routine obstetric care including antepartum care, cesarean delivery, and postpartum care, following attempted vaginal delivery after previous cesarean.
• 59620 – Cesarean delivery only, following attempted vaginal delivery after previous cesarean.
• 59622 – Cesarean delivery only, including postpartum care, following attempted vaginal delivery after previous cesarean.