Billing That Follows Every Patient From the First Visit to Postpartum Care
From well-woman exams and in-office procedures to global maternity packages and GYN surgery, our OB/GYN-trained coders manage claims for practices across the United States — so antepartum care, delivery, and every follow-up get billed the way they were actually delivered.
Denied — CO-97 (bundled)
99213 office visit for pregnancy-related nausea denied as included in the global OB package 59400.
Corrected by our team
Chart note reviewed; visit qualified as a separately identifiable complication. Modifier 25 applied with supporting documentation and resubmitted.
Paid in full
Allowed amount recovered: $148.20 · root cause added to our global-period checklist.
OB/GYN Revenue Hides in the Details Other Billers Miss
OB/GYN billing mixes long-arc maternity care with high-volume in-office diagnostics and surgery — a combination that trips up generalist billing teams. These are the four places we see practices lose money most often.
Global maternity packages & fragmented care
59400 and 59510 bundle antepartum visits, delivery, and postpartum care into one code — but pregnancies rarely stay with a single provider. Transfers, payer changes mid-pregnancy, and losses before viability each need different code sets, and billing the wrong combination strands revenue in an unbillable global.
Preventive exams collide with problem visits
A well-woman exam and a same-day problem visit for a new complaint are billed differently, but payers default to assuming duplication. Without modifier 25 and documentation that separates the two, one visit gets denied.
Ultrasound & diagnostic frequency edits
Obstetric ultrasounds and screenings like NST carry payer frequency limits and strict medical-necessity rules. A repeat scan coded without a distinct diagnosis, or billed past the allowed frequency, comes back denied regardless of clinical need.
Surgical globals & same-day bundling
Hysterectomy carries a 90-day global, and NCCI edits bundle colposcopy, biopsy, and D&C codes tightly. Without modifiers like 59/XU or 24/79 backed by documentation, related same-day or post-op services get absorbed for $0.
One Global Code, or Three Separate Ones?
Every pregnancy is billed one of two ways — and picking the wrong one either loses reimbursement or triggers a duplicate-service denial. Here's how the same 40 weeks of care are billed under each path.Loss before viability, transfer of care, and multi-provider delivery all route down the split-care path — the most common source of missed OB revenue we find during onboarding audits.
Full Revenue-Cycle Coverage, Organized the Way Your Claims Flow
Every service below is delivered by staff who work OB/GYN claims daily — and each connects to the same end-to-end RCM platform behind all our medical billing services.
Before the Visit
- Insurance eligibility verification for every antepartum, GYN, and surgical encounter
- Prior authorization for GYN surgery, advanced imaging, and genetic screening
- Benefit checks across office, hospital, and ASC settings
- Patient responsibility estimates before delivery and surgical procedures
Coding & Submission
- OB/GYN-specific CPT & ICD-10 coding from visit notes and operative reports
- Global-period tracking across the full antepartum-to-postpartum arc
- Charge entry with accurate antepartum visit counts
- Clean electronic claim submission to all payers
Getting You Paid
- Payment posting & underpayment detection against global fee schedules
- Denial management with documented, payer-specific appeals
- A/R follow-up on every unpaid or transfer-of-care balance
- Patient billing & statements + monthly reporting
The OB/GYN Codes We Work With Every Day
A sample of the procedure families our coders handle — and the modifier decisions that determine whether they're paid correctly.
Frequently billed OB/GYN CPT codes
| CPT | Procedure | What we watch for |
|---|---|---|
| 59400 | Global OB care (antepartum + vaginal delivery + postpartum) | Only billable when one practice provides the complete course; split care needs 59425/59426 + 59409/59410 instead |
| 59510 | Global cesarean delivery care | Same continuity rule as 59400; prior vaginal delivery history can affect code selection |
| 59425 / 59426 | Antepartum care only, 4–6 / 7+ visits | Used after a transfer or delivery elsewhere; visit count must match the chart exactly |
| 59409 / 59514 | Vaginal / cesarean delivery only | Delivery-only billing when antepartum or postpartum care was provided by another practice |
| 59430 | Postpartum care only | Applies when delivery happened elsewhere; frequently missed after a mid-pregnancy transfer |
| 58150 | Total abdominal hysterectomy | 90-day global; op note must clearly support the surgical approach |
| 58571 | Laparoscopic hysterectomy w/ tube(s)/ovary(s), uterus ≤250g | Uterine weight documentation drives correct code selection within the 5857x family |
| 58558 | Hysteroscopy, D&C | Bundled with related endometrial biopsy codes under NCCI unless a distinct service applies |
| 57454 | Colposcopy with biopsy | Frequently billed same-day as a problem E/M; modifier 25 documentation required |
| 76805 / 76811 | Obstetric ultrasound, standard / detailed | Payer frequency limits; repeat scans need a distinct medical-necessity diagnosis |
| 88175 | Cytopathology, Pap smear, automated | Screening vs. diagnostic diagnosis coding changes patient cost-share entirely |
| 58300 | IUD insertion | Device billed separately (HCPCS) from the insertion procedure itself |
Modifiers that make or break OB/GYN reimbursement
| Modifier | When it applies in OB/GYN | Cost of getting it wrong |
|---|---|---|
| -25 | Significant, separately identifiable E/M on the same day as a procedure (colposcopy, IUD insertion, biopsy) | The office visit is absorbed into the procedure and goes unpaid |
| -59 / XU | Distinct procedural service when NCCI would otherwise bundle (e.g., biopsy at a separate cervical site) | CO-97 bundling denial, or audit risk if applied without documentation |
| -52 | Reduced services — antepartum care ending before delivery (loss, transfer) | Full global fee billed for incomplete care, inviting a payer audit |
| -22 | Increased procedural services — complicated delivery or surgery requiring significantly more work | Reimbursed at the standard rate despite documented extra time and complexity |
| -TH | Obstetric treatment/services, prenatal or postpartum, on antepartum-period E/M | Missing it can misclassify antepartum visits against global-period edits |
| -24 | Unrelated E/M during a postoperative global (new GYN complaint after hysterectomy) | Visit denied as included in the surgical global |
Tables are illustrative, not exhaustive — our coders work across the full OB/GYN code set, payer policies, and annual CPT/NCCI updates.
How We Take Over Your OB/GYN Billing — Without Disrupting It
Audit & Onboard
We review your current A/R, global-period billing patterns, and denial history, then map your EHR workflow — no system change required.
Verify & Authorize
Eligibility runs before every visit; prior auths for GYN surgery, advanced imaging, and genetic screening are secured and tracked to the claim.
Code & Submit
Visit notes and operative reports are coded by OB/GYN-trained staff, checked against NCCI edits and global-period rules, and submitted clean within 24–48 hours.
Post, Appeal & Report
Payments post daily, denials are appealed with documentation, and you get a plain-English monthly report on collections and trends.
A Billing Partner That Speaks OB/GYN
Specialty-trained, not general-purpose
The team on your account works OB/GYN claims daily — global maternity packages, well-woman and problem-visit overlaps, and GYN surgical globals — so nothing gets coded by guesswork.
Prevention over rework
We scrub every claim against NCCI edits, payer policy, and global-period rules before it leaves the building. Denials that slip through are appealed, and their root cause is engineered out of your workflow.
Your systems, your data, full visibility
We work inside your existing EHR and practice management software with HIPAA-compliant access. You see everything we do, and monthly reports translate billing performance into decisions you can act on.
One partner for the whole cycle
Because we run the complete revenue cycle — from eligibility through A/R follow-up — nothing falls between vendors, and accountability for your revenue sits in one place.
OB/GYN Billing Questions, Answered Directly
What makes OB/GYN billing different from general medical billing?
Global maternity packages, the overlap between preventive well-woman visits and problem-focused care, and tight NCCI bundling on GYN procedures create billing scenarios generalist billers rarely see. Getting antepartum visit counts, delivery codes, and modifier 25 right is the difference between a clean claim and a bundling denial.
How do you bill pregnancies where care is split between providers?
When a patient transfers care, delivers with another practice, or the pregnancy ends before delivery, we bill antepartum-only (59425/59426), delivery-only (59409/59514), or postpartum-only (59430) codes instead of the global package — matched exactly to the visit count and services your practice actually provided.
Do you handle prior authorization for GYN surgery?
Yes. We manage authorizations for hysterectomy, laparoscopic and robotic-assisted procedures, advanced imaging, and genetic or high-risk pregnancy screening, submitting clinical documentation up front so scheduled surgery isn't delayed.
Can you bill a well-woman exam and a problem visit on the same day?
Yes, when documentation supports it. We apply modifier 25 with a chart note that separates the preventive exam from the problem-focused component, so both the screening and the sick visit are reimbursed instead of one being denied as duplicate.
How do you reduce denials tied to global periods?
We track every patient's global-period clock — antepartum through postpartum, and 90-day surgical globals — so unrelated visits are coded with modifiers 24 and 79 instead of being absorbed for $0, and staged or complicated care is coded with 58 and 22 where documentation supports it.
Will we need to change our EHR or practice management system?
No. Our team works inside your existing platform. You keep your workflow and your data — we handle the billing within it.
This page reflects common CPT/ICD-10, NCCI, and global-period billing patterns for general information only; individual payer policies, contracts, and annual code updates vary. Confirm plan-specific rules before relying on any example above for a live claim.
Ready to Stop Losing Revenue to Global-Period Guesswork?
Send us a sample of recent EOBs and we'll show you, line by line, where your OB/GYN claims are leaking revenue — free of charge.