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Official Description

Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery;

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 59620 refers to a specific type of cesarean delivery that occurs after an attempted vaginal delivery in a patient with a history of a previous cesarean section. This procedure is commonly known as a cesarean delivery following a failed trial of labor or a failed vaginal birth after cesarean (failed VBAC). The process begins with routine obstetric care, which encompasses both antepartum and postpartum care. During the antepartum phase, the physician conducts a thorough maternal history and evaluates the health status of both the mother and fetus. This includes regular prenatal office visits, which are scheduled monthly for the first 28 weeks of gestation, biweekly visits until 36 weeks, and weekly visits thereafter. When the trial of labor does not result in a successful vaginal delivery, the patient is then prepared for a cesarean delivery. The physician administers an epidural or other form of anesthesia before making an incision in the abdomen. The uterus is then incised, and the amniotic fluid is suctioned out. Due to the attempted vaginal delivery, the baby's head is typically engaged in the pelvis, necessitating the physician to disengage the head before delivering it through the uterine incision. After the head is delivered, the physician clears the baby's airways by suctioning. The baby is subsequently removed from the uterus, while the physician checks for any complications such as umbilical cord entanglement. Once the baby is delivered, it is shown to the parents and placed in a warmer for examination and care by other medical staff. Following the delivery, the placenta is removed and examined, and the uterine incision is closed. The abdominal incision is also closed in layers. Post-delivery, the physician continues to provide care for the patient during her hospital stay and offers follow-up care after the cesarean delivery.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 59620 is indicated for patients who have previously undergone a cesarean delivery and are attempting a vaginal delivery but are unable to achieve a successful outcome. The following conditions may warrant this procedure:

  • Previous Cesarean Delivery: The patient has a history of at least one prior cesarean section.
  • Failed Trial of Labor: The patient has attempted a vaginal delivery but is unable to deliver vaginally, necessitating a cesarean delivery.
  • Failed Vaginal Birth After Cesarean (VBAC): The patient is unable to achieve a vaginal birth after a previous cesarean delivery.

2. Procedure

The procedure for CPT® Code 59620 involves several critical steps that ensure the safe delivery of the baby following a failed attempt at vaginal delivery. The following procedural steps are outlined:

  • Step 1: Prenatal Care: The physician provides routine prenatal care, which includes an initial maternal history and health evaluation, followed by regular office visits throughout the pregnancy. This ensures that both the mother and fetus are monitored closely.
  • Step 2: Transfer to Surgical Suite: Upon determining that the vaginal delivery has failed, the patient is transferred to the surgical suite for the cesarean delivery. An epidural or other anesthetic is administered to ensure the patient's comfort during the procedure.
  • Step 3: Surgical Incision: The physician makes an incision in the abdomen to access the uterus. This incision is carefully performed to minimize complications.
  • Step 4: Uterine Incision and Amniotic Fluid Removal: The uterus is incised, and the amniotic fluid is suctioned out to prepare for the delivery of the baby.
  • Step 5: Delivery of the Baby: Given that the baby's head is likely engaged in the pelvis due to the attempted vaginal delivery, the physician first disengages the head from the pelvis. The head is then delivered through the uterine incision, followed by suctioning of the baby's airways to clear any obstructions.
  • Step 6: Complete Delivery: The physician continues to remove the baby from the uterus while checking for any complications, such as umbilical cord entanglement. Once delivered, the baby is shown to the parents and placed in a warmer for further examination and care by medical staff.
  • Step 7: Placenta Removal: After the baby is delivered, the placenta is removed from the uterus and examined by the physician to ensure that it has been completely expelled.
  • Step 8: Closure of Incisions: The uterine incision is closed, followed by the closure of the abdominal incision in layers to promote healing.
  • Step 9: Post-Procedure Care: The physician provides post-cesarean care during the patient's hospital stay and schedules follow-up visits to monitor recovery.

3. Post-Procedure

After the cesarean delivery, the patient is monitored in the hospital for any complications that may arise from the surgery. The physician provides post-operative care, which includes pain management, monitoring for signs of infection, and ensuring proper healing of the surgical incisions. Follow-up office visits are scheduled to assess the patient's recovery and address any concerns. The physician also provides guidance on postpartum care, including physical activity restrictions and emotional support as the patient adjusts to motherhood.

Short Descr ATTEMPTED VBAC DELIVERY ONLY
Medium Descr CESAREAN DELIVERY ATTEMPTED VBAC
Long Descr Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery;
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) 0 - Co-surgeons not permitted for this procedure.
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)
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).
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
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).
GC This service has been performed in part by a resident under the direction of a teaching physician
U7 Medicaid level of care 7, as defined by each state
Date
Action
Notes
2010-01-01 Changed Code description changed.
1996-01-01 Added First appearance in code book in 1996.
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