Labor & Delivery Coding

Alaska Medicaid

NOTICE

Medicaid requires all prenatal, delivery, postpartum and newborn care be billed individually, by the visit UNLESS the patient has other insurance. 

In the event a patient has both private and medicaid insurance coverage, the private insurance is ALWAYS billed first. You can submit a global claim to the primary insurance if allowed and then bill to medicaid secondary. See the most current list of covered primary and secondary codes by visiting the Alaska Medicaid provider website and look-up your provider type fee schedule for the current reimbursement period. Any code not listed on this fee schedule will not be reimbursed by medicaid regardless of the primary insurance coverage. Codes requiring other insurance to pay as primary will note *TPL Required* (Third Party Liability). 

Medicaid fee schedules and covered codes lists are updated every year on July 1st and December 31st. 

Uncomplicated, Routine Labor / Delivery 

Click on a code for more detailed information

Common ICD-10 Codes

O80 - Encounter for Uncomplicated Vaginal Delivery

Z37.0 - Single Live Birth (Mothers ONLY)

Weeks Gestation (Required) 

Z3A._ _
00 =Unspecified

01 =Less than 8 weeks

08-42 = 8-42weeks

43 =greater than 42 weeks

O48.0 - Post Term Pregnancy

For more detailed or additional ICD-10 diagnoses coding, please reference any AMA certified coding software or look-up tools and manuals. Please, do NOT use google or other internet search engines for coding. 

Providers must be present at the time of delivery to charge for delivery coding. Otherwise, labor management or delivery of placenta may apply. Admit and discharge times as well as the type of discharge and newborn information is required. If multiples, the multiples B, C, D, etc will be billed as an additional delivery only charge with modifier. 

Medication coding can be found in Medications/Labs/Devices. May require a CLIA certificate. Most require an NDC Number

59400 - Routine Obstetrical Care including Antepartum Care, Vaginal Delivery (with or without episiotomy, and/or forceps) and Postpartum Care. - 3 or more prenatal visits minimum. All care must be with this provider since only one global code is allowed per pregnancy. Delivery codes include all professional services that are reasonably assumed inclusive to a vaginal delivery (sutures, etc). 

59409 - Vaginal Delivery Only (with or without episiotomy an/or forceps) - Delivery codes include all professional services that are reasonably assumed inclusive to a vaginal delivery (sutures, etc). 

59410 - Vaginal Delivery Including Postpartum Care - Includes all routine postpartum follow-up visits.

59414 - Delivery of Placenta - Separate procedure, cannot be billed in addition to delivery charge, even under a secondary provider in attendance. 

59610 - Routine Obstetrical Care including Antepartum Care, Vaginal Delivery (with or without episiotomy, and/or forceps) and Postpartum Care after previous cesarean delivery3 or more prenatal visits minimum. All care must be with this provider since only one global code is allowed per pregnancy. Delivery codes include all professional services that are reasonably assumed inclusive to a vaginal delivery (sutures, etc). 

59612 - Vaginal Delivery Only (with or without episiotomy an/or forceps) after previous cesarean delivery - Delivery codes include all professional services that are reasonably assumed inclusive to a vaginal delivery (sutures, etc). 

59614 - Vaginal Delivery Only (with or without episiotomy an/or forceps) after previous cesarean delivery including postpartum care - Delivery codes include all professional services that are reasonably assumed inclusive to a vaginal delivery (sutures, etc). Includes all routine postpartum follow-up visits.

59899 - Unlisted Procedure, Maternity Care and Delivery (LABOR MANAGEMENT) - Requires name of delivery provider/physician with number of total minutes between admit and discharge. May require medical records for payment pricing. 

99499 - Evaluation and Management Services/Labor Support - Birth Doula - Most insurance do not reimburse for this service. 

For Birth Centers ONLY 

REV 0724 - Licensed Freestanding Birthing Center Admission thru Discharge Fee. Per 24hr period. Includes Newborn. See also 59409 for ALASKA

S4005 - Birthing Center Facility Fee when patient is transferred before delivery. - See also 59899 for ALASKA