OB/GYN billing, handled with care
Where ob/gyn billing gets difficult
The issues we see most often, and the ones that quietly cost practices the most.
Long billing timelines
Global maternity care is often billed after delivery, so details from the full pregnancy must be tracked for months.
Mid-pregnancy changes
Transfers of care, insurance changes or a delivery by another provider can change how prenatal care is billed.
Separately billable services
Ultrasounds, lab work and care for complications may be billed in addition to the package, but routine care is included.
Preventive gynecology
Annual exams, screenings and contraception services have specific coding and coverage rules that vary by payer.
How we handle them
Pregnancy-level tracking
We track each pregnancy from the first visit, including payer notifications, visit counts and any changes in coverage.
Package or itemized billing
We decide between global, partial or itemized billing based on the care your practice actually provided.
Separate service review
We review prenatal records for services outside routine care that may be separately billable.
Preventive coding support
We code preventive visits and screenings so patients receive the coverage they are entitled to.
Coding notes
General guidance only. Code sets update every year and payer policies vary, so we check current rules on every claim.
- Global obstetric package
- 59400 covers routine antepartum care, vaginal delivery and postpartum care, and 59510 covers the same with cesarean delivery. 59610 and 59618 apply to deliveries after a previous cesarean.
- When to bill separately
- If a practice does not provide all package components, partial codes may apply, such as 59425 or 59426 for antepartum care only and 59430 for postpartum care only. One to three prenatal visits are generally billed as E/M services.
- Services outside the package
- Ultrasounds, labs, visits for unrelated conditions and management of certain complications are generally billed separately. Payers differ on what counts as routine care.
OB/GYN billing questions
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