OB/GYN Billing Services
OB/GYN billing services including global obstetric package billing, antepartum care, delivery coding.
How the Global Obstetric Package Works
Obstetric care is usually billed as a global package covering antepartum care, delivery and postpartum care together. When a patient transfers care or the course changes, the package has to be unbundled and billed by component instead.
- Global package billed where the full course of care was provided
- Component billing applied when care transfers mid-pregnancy
- Delivery method and complications reported as documented
- Gynecologic procedures billed separately from obstetric care
OB/GYN Billing Services Explained
OB/GYN billing has two distinct tracks: obstetrics billing operates on a global package model that bundles antepartum visits, delivery, and postpartum care into a single code, while gynecology billing uses standard procedure and E/M coding for office and surgical services. CPT code selection rules for obstetric global packages are defined by the American Medical Association, errors occur when practices incorrectly split global package components or apply the wrong delivery code based on route and circumstances.
Medsure RCS manages OB/GYN medical coding for Florida practices with coders experienced in global obstetric package billing, planned and unplanned cesarean billing, and gynecologic procedure coding. We handle charge capture from the first antepartum visit through postpartum discharge and the full gynecology procedure code set. OB/GYN is part of our specialty medical billing program. Prenatal and postpartum services carry modifier TH where the payer requires it.
How It Works: Step by Step
Obstetric Package Tracking
Each patient's antepartum visit count is tracked against the global package requirements, and any services outside the global period are identified for separate billing.
Delivery Code Selection
Delivery codes are selected based on delivery route (vaginal, cesarean), whether the physician performed antepartum care, and whether complications were present that require additional coding.
Gynecology Procedure Billing
GYN procedure codes are assigned based on surgical approach (laparoscopic vs open), anatomic site, and complexity with correct modifier application for bilateral or staged procedures.
Postpartum and Newborn Billing
Postpartum office and hospital visits are billed correctly for services outside the global period, and attending physician newborn care is billed separately from the obstetric package.
Why This Matters for Your Revenue Cycle
Every obstetric global package claim uses the correct delivery code with accurate antepartum care documentation.
OB/GYN-specific code review and global package validation drives first-pass acceptance above 95%.
Delivery claims are submitted within 14 days of delivery for immediate revenue cycle entry.
Global package components are never billed separately unless the circumstances qualify for package unbundling.
Common Mistakes in OB/GYN Billing Services
Splitting the Global Package Incorrectly
The global obstetric package (59400, 59510, 59610) includes routine antepartum visits, delivery, and 6-week postpartum care. Billing antepartum visits separately without proper documentation that the global package was not billed creates an overpayment issue.
Wrong Cesarean Code After Planned Vaginal Delivery
When a vaginal delivery attempt is converted to a cesarean section, the correct code (59618, 59620, 59622) differs from a planned cesarean (59510, 59514, 59515). Using the planned code when the delivery was after a failed vaginal attempt results in incorrect billing.
Billing Hospital Admissions During Global Period
Routine hospital admissions for active labor and normal delivery monitoring are part of the global package. Billing a separate admission code for labor monitoring without a separately identifiable service results in a bundling denial.
Missing Diagnosis Code for High-Risk Pregnancy
High-risk pregnancy conditions including gestational diabetes, preeclampsia, and placenta previa require specific ICD-10-CM codes that affect medical necessity for additional visits, testing, and consultations. Missing these codes reduces supportable claim volume.
How Medsure RCS Manages OB/GYN Billing Services
Global Obstetric Package Billing
Complete global package billing (59400-59622) with delivery route, antepartum care count, and postpartum period management.
High-Risk Obstetric Billing
Antepartum management billing for high-risk pregnancies with correct ICD-10 coding for complicating conditions.
Gynecology Procedure Coding
Laparoscopic and open GYN procedures including hysterectomy, myomectomy, and endometriosis excision with correct approach and complexity coding.
GYN Office Procedure Billing
IUD insertion and removal, colposcopy, LEEP, and endometrial biopsy coding with correct E/M plus procedure billing.
Prenatal Visit Billing for Non-Global Situations
When the delivering physician differs from the prenatal care provider, individual antepartum visit codes are applied correctly for each provider.
Newborn Attendance Billing
Attendance at cesarean deliveries and high-risk deliveries is billed correctly when a separate physician provides immediate newborn care.
Related Services
OB/GYN Billing Services, Frequently Asked Questions
Antepartum visits can be billed separately when the physician who provided prenatal care is not the delivering physician, when care is transferred after a certain number of visits, or when the pregnancy ends before delivery (miscarriage, termination). Individual antepartum visit codes (59425, 59426) apply in these situations.
We split the global package based on the number of antepartum visits each provider completed. The delivering physician bills the appropriate global package code, and the previous provider bills antepartum-only codes (59425-59426) for their portion of care.
Yes. One routine postpartum office visit within the global period is included in the global obstetric package. Additional postpartum visits for complications or other medical concerns outside the routine postpartum exam are billed separately with modifier 24.
Yes. Office GYN procedures are billed with the procedure code plus modifier 25 when a significant, separately identifiable E/M was performed at the same visit. Documentation must support both the procedure and the separately identifiable E/M service.
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