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99%
OB/GYN

Specialized billing for obstetrics and gynecology, managing everything from routine wellness to complex deliveries.

Specialty highlight

99%

Built around payer rules, documentation requirements, and coding nuances.

Global OB Package Accuracy

99%

Clean Claim Rate

96%

Overview

Billing in OB/GYN

A practical view of what makes this specialty unique.

OB/GYN billing is uniquely challenging, combining preventive gynecological care with the complex, time-intensive global episodes of obstetrical care. Our service is designed to manage the full spectrum of your practice, from annual well-woman exams and in-office procedures to antepartum care, delivery, and postpartum follow-up. We ensure accurate coding for all services, proper handling of global obstetrical packages, and maximized reimbursement for both medical and surgical gynecology.

Comprehensive management of global OB packages, including antepartum, delivery, and postpartum care.

Standardized into our workflow to reduce rework and protect revenue.

Expertise in coding for vaginal deliveries, C-sections, and operative obstetrics.

Standardized into our workflow to reduce rework and protect revenue.

Accurate coding for gynecological surgeries (hysterectomy, D&C) and in-office procedures.

Standardized into our workflow to reduce rework and protect revenue.

Billing for family planning services, IUD insertions, and implantable contraceptives.

Standardized into our workflow to reduce rework and protect revenue.

Challenges

What slows reimbursement

The common friction points that trigger delays, denials, and rework.

Key challenges
  • Managing the global obstetrical package, which includes antepartum, delivery, and postpartum care.
  • Accurately coding for vaginal deliveries, C-sections, and the numerous complications that can arise.
  • Distinguishing between covered gynecologic procedures and non-covered services.
  • Billing for a high volume of in-office procedures (colposcopy, LEEP, IUD insertions).
  • Ensuring correct coding for high-risk obstetrical care and ultrasound interpretations.
Our solutions
  • Certified OB/GYN coders with in-depth knowledge of CPT and ICD-10 coding for obstetrics and gynecology.
  • Expert management of global obstetrical packages, tracking all visits and services within the episode of care.
  • Precise coding for all types of deliveries and associated surgical procedures.
  • Accurate billing for a full range of gynecological surgeries and in-office procedures.
  • Proactive verification of insurance benefits and coordination of maternity coverage.
  • Detailed support for ultrasound and other diagnostic imaging coding.
Features

Operational features that keep claims clean

Repeatable checks, payer alignment, and tight charge capture.

Comprehensive management of global OB packages, including antepartum, delivery, and postpartum care.

Included to improve first-pass acceptance and reduce downstream edits.

Expertise in coding for vaginal deliveries, C-sections, and operative obstetrics.

Included to improve first-pass acceptance and reduce downstream edits.

Accurate coding for gynecological surgeries (hysterectomy, D&C) and in-office procedures.

Included to improve first-pass acceptance and reduce downstream edits.

Billing for family planning services, IUD insertions, and implantable contraceptives.

Included to improve first-pass acceptance and reduce downstream edits.

Management of ultrasound and diagnostic testing coding.

Included to improve first-pass acceptance and reduce downstream edits.

Coding

Coding complexities we watch closely

Modifier usage, documentation rules, and specialty-specific payer edits.

Complexity checklist
  • Global OB coding using the appropriate code based on the type of delivery (59400, 59510, 59610, 59618).
  • Separate billing for antepartum visits only (59425, 59426) when not providing delivery.
  • Coding for complications of pregnancy (O20-O29) and their impact on delivery codes.
  • Correct use of modifiers for bilateral procedures and multiple surgeries.
Denial triggers

Incorrect coding of global OB packages (e.g., billing for antepartum visits separately).

Missing modifiers for bilateral or multiple procedures.

Unbundling of surgical procedures.

Lack of medical necessity for diagnostic tests like ultrasound.

Coordination of benefits errors for maternity care.

Codes

Common codes (examples)

Reference-only examples to illustrate the typical coding landscape.

CPT

59400 (Vaginal Delivery), 59510 (C-Section), 76805 (OB Ultrasound), 58150 (Total Hysterectomy), 99214 (Office Visit)

ICD-10

Z34.90 (Normal Pregnancy), O80 (Encounter for Full-Term Delivery), N92.0 (Menorrhagia), N83.2 (Ovarian Cyst), Z12.4 (Screening for Malignant Neoplasm of Cervix)

FAQ

Frequently Asked Questions

Got questions? We've got answers

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