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CPT® Code 59514 refers specifically to a cesarean delivery performed without the inclusion of antepartum and postpartum care. This procedure is a surgical method of delivering a baby through an incision made in the mother's abdomen and uterus. The decision to perform a cesarean delivery may be made prior to the onset of labor, often in cases where complications are anticipated, or it may occur during labor if maternal or fetal complications arise. The procedure typically involves the administration of anesthesia, such as an epidural, to ensure the comfort of the mother during the surgery. The physician carefully makes an incision in the abdomen, followed by an incision in the uterus to access the amniotic fluid and the baby. If the baby's head is engaged in the pelvis, the physician will first disengage it before delivering the head through the uterine incision. After the baby is delivered, the physician ensures that the airways are clear by suctioning, and the baby is then shown to the parents before being placed in a warmer for further examination by medical staff. Following the delivery, the placenta is removed and examined, and the uterine incision is closed, followed by the closure of the abdominal incision in layers. This code is utilized when the cesarean delivery is the only service provided, distinguishing it from other codes that include comprehensive care before and after the delivery.
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The indications for performing a cesarean delivery under CPT® Code 59514 include the following:
The procedure for a cesarean delivery as described under CPT® Code 59514 involves several critical steps:
Post-procedure care following a cesarean delivery includes monitoring the mother for any complications related to the surgery, such as infection or excessive bleeding. The physician provides follow-up care in the hospital to ensure the mother's recovery is progressing well. It is important for the mother to receive appropriate pain management and support during her recovery. Additionally, the physician will schedule post-cesarean office follow-up visits to assess the healing process and address any concerns the mother may have regarding her recovery and the care of her newborn.
| Short Descr | CESAREAN DELIVERY ONLY | Medium Descr | CESAREAN DELIVERY ONLY | Long Descr | Cesarean delivery only; | Status Code | Active Code | Global Days | MMM - Maternity Code | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Inpatient Procedures, not paid under OPPS | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 134 - Cesarean section |
This is a primary code that can be used with these additional add-on codes.
| 59525 | Maternity Edit Female Edit Addon Code MPFS Status: Active Code APC C PUB 100 CPT Assistant Article Illustration for Code Subtotal or total hysterectomy after cesarean delivery (List separately in addition to code for primary procedure) |
| 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | GC | This service has been performed in part by a resident under the direction of a teaching physician | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 62 | Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate. | 81 | Minimum assistant surgeon: minimum surgical assistant services are identified by adding modifier 81 to the usual procedure number. | AG | Primary physician | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | CG | Policy criteria applied | CR | Catastrophe/disaster related | GB | Claim being re-submitted for payment because it is no longer covered under a global payment demonstration | Q5 | Service furnished under a reciprocal billing arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | SA | Nurse practitioner rendering service in collaboration with a physician | SB | Nurse midwife | TH | Obstetrical treatment/services, prenatal or postpartum | U1 | Medicaid level of care 1, as defined by each state | U2 | Medicaid level of care 2, as defined by each state | U7 | Medicaid level of care 7, as defined by each state | U9 | Medicaid level of care 9, as defined by each state | UB | Medicaid level of care 11, as defined by each state | UC | Medicaid level of care 12, as defined by each state | UD | Medicaid level of care 13, as defined by each state | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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Notes
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| 2010-01-01 | Changed | Code description changed. |
| 1994-01-01 | Added | First appearance in code book in 1994. |
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