Why OB/GYN billing is different.
OB/GYN billing expertise.
- Global maternity care for vaginal and cesarean delivery
- Antepartum-only and postpartum-only billing when care is split
- High-risk pregnancy visits and testing outside the global
- Obstetric ultrasound and fetal monitoring coding
- Gynecologic surgery and global period tracking
- Contraception and IUD insertion billing
- Colposcopy and cervical screening coding
- Well-woman preventive visit billing
Common OB/GYN codes we work with.
| Code | Description |
|---|---|
59400 | Routine obstetric care including antepartum care, vaginal delivery and postpartum care |
59510 | Routine obstetric care including antepartum care, cesarean delivery and postpartum care |
59025 | Fetal non-stress test |
76805 | Ultrasound, pregnant uterus, after first trimester, transabdominal; single or first gestation |
58300 | Insertion of intrauterine device (IUD) |
57454 | Colposcopy of the cervix with biopsy of the cervix and endocervical curettage |
CPT® is a registered trademark of the American Medical Association. Codes shown are examples; correct coding depends on documentation and payer policy.
Our processOB/GYN billing process.
Pregnancy Registration and Eligibility
- Maternity benefit verification at the first visit
- Tracking of estimated delivery date and coverage changes
- Prior authorization for ultrasounds and testing
- Patient estimates for global maternity charges
OB/GYN Coding
- Global package versus separately billable services
- High-risk visit and complication coding
- Ultrasound and fetal testing coding
- Gynecologic procedure and preventive visit coding
Claim Submission
- Global claim submission after delivery
- Split-care billing when patients transfer
- Scrubbing for maternity bundling edits
- Timely submission of non-global services
Denial Management
- Global package and duplicate billing disputes
- Coverage denials for prenatal testing
- Corrected claims for insurance changes
- Appeals with prenatal records
Reporting
- Deliveries and global revenue by provider
- Open pregnancy tracking
- Gynecology procedure revenue
- Payer reimbursement trends
OB/GYN billing FAQs.
When is global maternity care billed?
The global obstetric code is typically billed after delivery and covers routine antepartum visits, the delivery and routine postpartum care. Services outside that package, such as treatment of complications, are billed separately.
What if a patient transfers to our practice mid-pregnancy?
When a patient receives only part of her care from your practice, the global code can't be used. We bill antepartum-only, delivery-only or postpartum-only codes based on the care you actually provided.
Can ultrasounds be billed separately from the global package?
Yes. Obstetric ultrasounds and fetal non-stress tests are not part of routine global care and are billed separately when medically necessary.
How do you handle a well-woman exam with a problem visit?
If a separate problem is evaluated during the preventive visit, we bill the preventive service and a problem-oriented E/M with modifier -25 when the documentation supports it.