59622 Delivery

CPT 59622

CPT 59622: Cesarean After Attempted VBAC, Delivery Plus PostpartumCesarean After Attempted VBAC, Delivery Plus Postpartum

2027 change This code is scheduled for deletion on January 1, 2027, when CPT unbundles the global maternity package. Current rules apply through 2026 dates of service. See what replaces it →

The short answer

Use 59622 when your practice manages a trial of labor in a patient with a prior cesarean, performs the repeat cesarean when it converts, and provides routine postpartum care, but the antepartum course belongs elsewhere. Pair it with 59425, 59426, or per-visit E/M for whatever antepartum visits were yours. Full-span care is the global 59618; surgery with no follow-up is 59620.

Source: CMSSource: ACOGSource: CMS MPFS 2026

When to use 59622

Report 59622 for the delivery-plus-recovery slice of an attempted VBAC that ends in surgery: labor management, the cesarean, inpatient recovery, and the outpatient postpartum visits through the payer's global window. The typical patient transferred in during the third trimester or arrived in labor, converted to a repeat cesarean under your management, and stays with you through recovery. The antepartum thresholds do not move: 1 to 3 visits bill as E/M, 4 to 6 as 59425, 7 or more as 59426. Document the prior cesarean and the labor trial explicitly, or the payer will reprice the claim as the plain cesarean code 59515.

Documentation checklist

Everything the global code would need except the antepartum span, plus the transfer story that explains the missing piece.

✓ Prior cesarean documented with the diagnosis on the claim

✓ Labor course and the indication for conversion recorded

✓ Operative note with date and technique

✓ Transfer date establishing when care became yours

✓ Antepartum visit count at your practice, supporting the paired antepartum code

✓ Postpartum visits, including incision checks, within the payer's global window

✓ One billing entity across delivery and postpartum care

Global package rules

59622 is the global attempted-VBAC package 59618 minus antepartum care. The boundaries carry over: ultrasounds, non-stress tests, labs, and E/M for distinct problems bill separately, while routine postpartum visits and incision checks stay inside. Do not stack routine postpartum E/M on top of this code; that is the standard CO-97 in this family. See The Global OB Package, explained. ACOG

Reimbursement

2026 · national Medicare averages

Component	Work RVU	Total RVU	2026 rate
59622Delivery + postpartum	23.32	37.82	$1,263.22

National amounts under the 2026 Medicare Physician Fee Schedule (non-facility total RVU x $33.4009 conversion factor, no locality/MAC adjustment). Commercial and Medicaid rates differ. Verify current values with your MAC before billing.

Common denials

CO-97 Routine postpartum visits billed separately

Why it happens

Follow-up care inside the postpartum-inclusive code went out as standalone E/M claims.

How to fix

Routine postpartum care is inside 59622. Reserve separate E/M for distinct problems with their own diagnoses, with modifier 24 where a global period applies.

Source: NCCI

CO-16 VBAC attempt not supported on the claim

Why it happens

The claim lacked the prior-cesarean diagnosis or records reflecting a trial of labor.

How to fix

Resubmit with the history coded; supply labor documentation on review.

Source: CMS

CO-50 Repriced to the plain cesarean 59515

Why it happens

Review found no documented labor trial before the surgery.

How to fix

Appeal with the timed labor record and the conversion indication. Without a supportable trial, accept 59515 pricing.

Source: ACOG

CO-236 Billed with a global code

Why it happens

59622 appeared with 59618 for the same pregnancy.

How to fix

One structure per pregnancy. Remove the line that does not match the actual care span.

Source: NCCI

CO-119 Overlap with the transferring practice's claim

Why it happens

The prior practice billed globally across the transfer, so delivery and postpartum were already paid once.

How to fix

The transferring practice corrects to antepartum-only codes for its visit count; resubmit with the transfer date documented.

Source: CMS

FAQ

What is the CPT code description for 59622?

In plain language, 59622 covers a repeat cesarean after a trial of labor in a patient with a prior cesarean, plus routine postpartum care afterward, without the antepartum visits, which bill separately by count.

When is 59622 right instead of the global 59618?

When the antepartum course was not substantially yours: a late transfer or an in-labor arrival who converts to cesarean and stays through postpartum care.

How does 59622 differ from 59515?

Both cover cesarean plus postpartum without antepartum care. 59622 adds the documented trial of labor after a prior cesarean, and pays for that added intrapartum work. No labor trial, no 59622.

Which antepartum code pairs with it?

Match your visit count: individual E/M for 1 to 3 visits, 59425 for 4 to 6, 59426 for 7 or more, billed alongside the delivery code.

Are the postpartum incision checks separately billable?

Routine ones, no; they are inside the code. Managing a wound infection or other complication beyond routine care supports a separate claim with its own diagnosis.

CPT® is a registered trademark of the American Medical Association. Educational reference only, not billing, legal, or medical advice. Maintained by Ouma Health, a maternal-fetal telemedicine practice. Printed from obcodingguide.com, content current as of July 2026.