Maternity Obstetrical Care Medical Billing & Coding Guide for 2025

maternity obstetrical care medical billing, maternity obstetrical care, maternity obstetrics

Maternity billing is intricate, combining strict coding guidelines, insurance policies, and documentation. For OB/GYN practices, accurate billing is vital to ensure compliance, reduce denials, and optimize reimbursements.  

Let’s simplify and optimize your billing processes with this comprehnsive guide. 

At Neolytix, we simplify maternity billing with over 12 years of expertise, equipping providers with strategies to maximize efficiency and profitability, so you can focus on patient care while we streamline your billing processes. 

Table of Contents

maternity obstetrical care medical billing, maternity obstetrical care, maternity obstetrics

The Global Obstetrical Package

 The Global Obstetrical Package forms the backbone of maternity billing, consolidating routine antepartum, intrapartum, and postpartum care into a single payment.

The global obstetrical package consolidates maternity care into a single bundled payment for uncomplicated pregnancies, simplifying reimbursement for providers. It covers three primary care categories:  

  • Antepartum Care: Includes up to 13 routine prenatal visits, physical exams, and basic diagnostics (e.g., urinalysis). 
  • Intrapartum Care: Covers labor, delivery (vaginal or cesarean), and immediate postpartum recovery. 
  • Postpartum Care: Encompasses follow-up visits, breastfeeding support, and minor postpartum issue management.

Coders must review complete medical records, including progress notes and delivery reports, to ensure correct billing. If the services rendered do not meet the requirements for a total obstetric package, the coder is instructed to use appropriate stand-alone E&M code. 

maternity obstetrical care medical billing, maternity obstetrical care, maternity obstetrics

Currently, global obstetrical care is defined by the AMA CPT as “uncomplicated maternity cases which include antepartum, delivery, and postpartum care.” (Source: AMA CPT codebook 2024, page 450.)  

When billing for the global obstetrical package, the care must be provided by a single obstetrician, midwife, of the same physician group. Your medical practice is responsible for delivering the patient’s comprehensive routine obstetric care, including antepartum, delivery, and postpartum services.

maternity obstetrical care medical billing, maternity obstetrical care, maternity obstetrics

A “physician group practice” refers to a clinic or obstetric clinic operating under the same tax ID number. It uses either an electronic health record (EHR) system or a single hard-copy patient record. In this practice, each physician, nurse practitioner, or nurse midwife ensures that the patient has access to the same record and makes entries as services are provided. 

If the services provided do not meet the criteria for billing a complete obstetric (global package) package, the medical coder or biller should use the appropriate stand-alone codes. These could include separate evaluation and management codes, as well as specific codes for antepartum care only, delivery only, postpartum care only, or combinations like delivery and postpartum care  

Individual Evaluation and Management (E&M) codes should not be used to report maternity visits unless the patient presents with issues outside the global package for commercial payers.    

When discussing maternity obstetrical care medical billing, it is crucial to understand how to bill the Global Obstetrical Package.    

Most insurance carriers like Blue Cross Blue Shield, United Healthcare, and Aetna reimburse providers based on the global maternity package codes for services provided during the maternity period for complicated and uncomplicated pregnancies.   

Services Bundled with the Global Obstetrical Package

A key part of maternity obstetrical care medical billing is understanding what is and is not included in the Global Package.  

Antepartum Care

Antepartum care comprises the initial prenatal history and examination, as well as subsequent prenatal history and physical examination. This includes:   

  • All routine prenatal visits until delivery ( ≈ 13 encounters with patient) 
    • Monthly visits up to 28 weeks of gestation 
    • Biweekly visits up to 36 weeks of gestation 
    • Weekly visits from 36 weeks until delivery 
  • Recording of weight, blood pressures and fetal heart tones 
  • Routine chemical urinalysis (CPT codes 81000 and 81002) 
  • Education on breastfeeding, lactation and pregnancy (Medicaid patients) 
  • Exercise consultation or nutrition counseling during pregnancy 

IMPORTANT: Any other unrelated visits or services within this time period should be coded separately. Example: A patient comes in with the flu for this visit a E/M visit should be used.

Intrapartum Care AKA Labor & Delivery

Labor and delivery include the following:    

  • Admission to the hospital including history and physical.  
  • Inpatient evaluation and management (E/M) services provided within 24 hours of delivery.  
  • Management and fetal monitoring of uncomplicated labor  
  • Administration/induction of intravenous oxytocin (performed by provider not anesthesiologist)  
  • Insertion of a cervical dilator on same date as delivery, placement catheterization or catheter insertion, artificial rupture of membranes  
  • Removal of cerclage (if removed under anesthesia other than “local” it is a billable procedure)  
  • Vaginal, cesarean section delivery, delivery of placenta only (the operative report)   

NOTE: For any medical complications of pregnancy, see the above section “Services Bundled into Global Obstetrical Package.”  

Postpartum Care

maternity obstetrical care medical billing, maternity obstetrical care, maternity obstetrics

Postpartum care includes the following:  

  • Uncomplicated inpatient visits following delivery 
  • Repair of first- or second-degree lacerations (for lacerations of the third or fourth degree, see “Services Bundled into Global Obstetrical Package”)  
  • Simple removal of cerclage (not under anesthesia)  
  • Routine outpatient E/M services that are provided within 6 weeks of delivery (check insurance guidelines for exact postpartum period)  
  • Discussion of contraception prior to discharge  
  • Outpatient postpartum care – Comprehensive office visit  
  • Educational services, such as breastfeeding, lactation, and basic newborn care  
  • Uncomplicated treatments and care of nipple problems and/or infection
maternity obstetrical care medical billing, maternity obstetrical care, maternity obstetrics

All the above should be billed using one CPT code. Separate CPT codes should not be reimbursed as part of the global package. 

Services Excluded from the Global Obstetrical Package

Certain procedures, either due to complexity or limited applicability, are billed separately. If the provider performs any of the following procedures during the pregnancy, separate billing should be done as these procedures are not included in the Global Package.  Examples include:  

  • Initial E/M to diagnose pregnancy if antepartum record is not initiated at this confirmatory visit  
    • This confirmatory visit (amenorrhea) would be supported in conjunction with the use of ICD-10-CM diagnosis code Z32.01.  
    • This is usually done during the first 12 weeks before the ACOG antepartum note is started. Use CPT Category II code 0500F.  
  • Laboratory tests (excluding routine chemical urinalysis)   
    • Examples include CBC, liver functions, HIV testing, Blood glucose testing, sexually transmitted disease screening, and antibody screening for Rubella or Hepatitis, etc.  
  • Cerclage, or the insertion of a cervical dilator more than 24 hours from admission.  
  • External cephalic version (turning of the baby due to malposition)  
  • Amniocentesis (any method) 
  • Amnioinfusion  
  • Chorionic villus sampling (CVS)  
  • Fetal contraction stress test   
  • E/M services for management of conditions unrelated to pregnancy during antepartum or postpartum care. The diagnosis should support these services.  
    • Examples include cardiac problems, neurological problems, diabetes, hypertension, hyperemesis, preterm labor, bronchitis, asthma, and urinary tract infection  
    • NOTE: These encounters could be office visits, clinic visits, emergency room, or inpatient admission/observation.   
  • Inpatient E/M services provided more than 24 hours before delivery  
  • Surgical Procedures during pregnancy  
    • Examples include urinary system, nervous system, cardiovascular, etc.  
  • Laceration repair of a third- or fourth-degree laceration at the time of delivery. 
    • Per ACOG coding guidelines, this should be reported using modifier 22 of the CPT code used to bill.  
  • Contraceptive management services (insertions only)  

Split Billing Scenarios

Split billing is necessary when care isn’t provided continuously by one provider or group. Common scenarios include:  

  • Late Prenatal Care: The patient begins care after receiving services elsewhere. 
  • Provider Changes: Transfers due to relocation or preference. 
  • Partial Care: Specific care segments (e.g., delivery only). 

Navigating Split Billing: 

  1. Notify insurers about changes to avoid claim denials. 
  2. Use appropriate codes, such as: 
    • Antepartum Care Only: 59425 (4-6 visits) or 59426 (7+ visits).
    • Delivery Only: 59409 (vaginal delivery) or 59514 (cesarean delivery).
    • Postpartum Care Only: 59430. 
  3. Ensure thorough documentation to justify split billing. 
maternity obstetrical care medical billing, maternity obstetrical care, maternity obstetrics
The AMA categorizes Maternity care and delivery CPT codes. The following is a comprehensive list of all CPT codes for full term pregnant women.    IMPORTANT: Complications of pregnancy such as abortion (missed/incomplete) and termination of pregnancy are not included in this list.    The following codes can also be found in the 2025 CPT codebook.  
CPT  Description  Package 
59400  Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care, after previous cesarean delivery  Global Package Code       Vaginal Delivery 
59409  Vaginal delivery only (with or without episiotomy and/or forceps);  Itemization Code 
59410  Vaginal delivery only (with or without episiotomy and/or forceps); including postpartum care  Itemization Code 
E/M  Antepartum care only; 1-3 visits  Itemization Code 
59425  Antepartum care only; 4-6 visits  Itemization Code 
59426  Antepartum care only; 7 or more visits  Itemization Code 
59430    Postpartum care only (separate procedure)  Itemization Code 
59510  Routine obstetric care including antepartum care, cesarean delivery, and postpartum care  Global Package Code       C-Section  Delivery 
59514  Cesarean delivery only;  Itemization Code 
59515  Cesarean delivery only; including postpartum care  Itemization Code 
59610  Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care, after previous cesarean delivery  Global Package Code   VBAC Delivery 
59612  Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps);  Itemization Code 
59614  Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps); including postpartum care  Itemization Code 
59618  Routine obstetric care including antepartum care, cesarean delivery, and postpartum care, following attempted vaginal delivery after previous cesarean delivery  Global Package Code   VBAC Delivery 
59620  Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery;  Itemization Code 
59622  Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery; including postpartum care  Itemization Code 
maternity obstetrical care medical billing, maternity obstetrical care, maternity obstetrics

Maternity Obstetrical Care Medical Billing for Twin Delivery/Multiple Gestation

Twin deliveries bring both joy and complexity to maternity care, and your billing process is no exception. When patients are carrying more than one fetus, specialized coding is essential to ensure accurate reimbursement and compliance. 

 The American College of Obstetricians and Gynecologists (ACOG) has established clear guidelines for coding twin deliveries, whether vaginal, cesarean, or a combination of the two. By adhering to these codes, your practice can ensure proper billing and minimize claim rejections. Here’s how to get it right: 

Type of Twin 

CPT Codes Reported 

Twin A 

59400 

Twin B 

59400-59 

Twin A & Twin B 

59510 

Delivery of Twins 

59618 

Twin A 

59610 

Twin B 

59612-59 

Twin B 

59510 

Twin A 

59409-51 

Twin B 

59618 

Twin A 

59612-51 

Key Considerations for Cesarean Deliveries  

  • Single Cesarean: Use code 59510 for routine care, covering antepartum, cesarean delivery, and postpartum. 
  • Complex Cases: Append Modifier 22 for difficult cesareans and include the operative report.  

Accurate coding and modifiers ensure timely reimbursements and effective care. Neolytix can help simplify the process and ensure compliance. 

Rejected Claims?
Not sure why Insurance is rejecting your simple claims?
Ask us for Help!

Partial Patient Care Billing

Some patients may come to your practice late in their pregnancy. Others may switch from your practice prior to delivery. In these circumstances, your practice will need to bill for services rendered 

Examples of situations include:  

  • The patient has received part of her antenatal care somewhere else (e.g. from another group practice).   
  • The patient leaves her care with your group practice before global OB care is complete.  
  • The patient has a change of insurer during her pregnancy. (e.g. Commercial coverage to Medicaid or vice versa) 

In these situations, your practice should contact the insurance carrier and notify them of these changes. This will allow reimbursement for services rendered. If the patient has fewer than 13 encounters with the provider, your practice should contact the insurer to find out whether the insurer will honor the global package CPT code. Billings include:    

  • Antepartum care only. The following CPT codes apply based on how many visits a patient had with your practice. For fewer than 13 encounters, confirm with insurers whether the global package code applies. Use appropriate codes for specific services: 
  • Antepartum Care Only: 59425 (4-6 visits) or 59426 (7+ visits); E/M code for 1-3 visits. 
  • Delivery Only: 59409 (vaginal), 59514 (cesarean), 59612, or 59620. 
  • Postpartum Care Only: 59430.  

Clear documentation and communication with insurers ensure accurate payments for split services. 

maternity obstetrical care medical billing, maternity obstetrical care, maternity obstetrics

Maternity Obstetrical Care Medical Billing for High-Risk Pregnancies

High-risk pregnancies require enhanced monitoring and care due to increased risks to the mother, baby, or both. These cases often demand more than 13 prenatal visits and specialized interventions.  

Examples of High-Risk Pregnancy Conditions: 

  • Advanced Maternal Age (AMA): Risks increase for mothers over 35. 
  • Maternal Health Issues: Hypertension, diabetes, epilepsy, thyroid disorders, and poorly controlled asthma. 
  • Pregnancy-Related Complications: Gestational diabetes, pre-eclampsia, abnormal placenta position, or preterm labor.  

All these conditions require a higher and closer degree of patient care than a patient with an uncomplicated pregnancy.  

As such, in some cases visits for a high-risk pregnancy are not considered routine.  Per ACOG, all services rendered by MFM are outside the global package when the patient care is being co-managed by both their general obstetrician and MFM provider. Unless the patient sees the MFM provider during their entire pregnancy then a global package is appropriate. An MFM provider is allowed to bill for E/M services along with any procedures performed (such as ultrasounds, fetal doppler, etc.) with a modifier 25 when appropriate.    

Be sure to verify all insurance guidelines to see how MFM services should be reported if the provider and MFM are within the same group practice.  The claim should be submitted with an appropriate high-risk or complicated diagnosis code.  

Examples of applicable ICD-10-CM codes: 

ICD-10-CM 

Description 

O09.8 

Supervision of other high-risk pregnancies 

O10.11 

Pre-existing hypertensive heart disease complicating pregnancy 

O11. 

Pre-existing hypertension with pre-eclampsia 

O12 

Gestational [pregnancy-induced] edema and proteinuria without hypertension 

O14 

Pre-eclampsia 

O24.01 

Pre-existing type-1 diabetes mellitus, in pregnancy, childbirth, and the puerperium 

O26.61 

Liver and biliary tract disorders in pregnancy, childbirth, and the puerperium 

O99-0 

Anemia complicating  pregnancy, childbirth, and the puerperium 

maternity obstetrical care medical billing, maternity obstetrical care, maternity obstetrics

On October 1, 2024, new ICD-10-CM codes were released to expand diagnosis codes that pertain to diabetes during pregnancy, obesity, hypoglycemia and more.  

Code  

Description 

E10.A0 

Type 1 diabetes mellitus, presymptomatic, unspecified 

E10.A1 

Type 1 diabetes mellitus, presymptomatic, Stage 1 

E10.A2 

Type 1 diabetes mellitus, presymptomatic, Stage 2 

E16.A1 

Hypogylcemia level 1 

E16.A2 

Hypogylcemia level 2 

E16.A3 

Hypogylcemia level 3 

E66.811 

Obesity, class 1 

E66.812 

Obesity, class 2 

E66.813 

Obesity, class 3 

F50.01- 

Anorexia nervosa, restricting type 

F50.02- 

Anorexia nervosa, binge eating/purging type, mild 

F50.2- 

Bulimia nervosa, unspecified 

F50.8- 

Other eating disorders 

Z15.1 

Genetic susceptibility to epilepsy and neurodevelopmental disorders 

Z15.2 

Genetic susceptibility to obesity 

Z17.2- 

Codes specific to progesterone receptor status 

Z17.3- 

Codes specific to human epidermal growth factor status 

Z17.41 

Codes specific to hormone receptor and human epidermal growth factor receptor status 

Z59.71 

Insufficient health insurance coverage (SDoH) 

Z59.72 

Insufficient welfare support (SDoH) 

maternity obstetrical care medical billing, maternity obstetrical care, maternity obstetrics

When a patient who is considered high risk during her pregnancy has an uncomplicated delivery with no special monitoring or other activities, it should be coded as a normal delivery according to ICD-10-CM guidelines.  

Example: Patient is expected to be 35 years old at the time of delivery at 40 weeks (about 9 months) gestation.  O09.523: Supervision of elderly multigravida. However, a patient delivers a healthy fetus at 35 weeks (about 8 months) gestation during a normal delivery at the age of 34 years old. The proper diagnoses codes should be O80 for normal vaginal birth, Z3A.35 for 35 weeks (about 8 months) gestation and Z37.0 for normal outcome of delivery.  

Ultrasound Billing

Ultrasound procedures are a cornerstone of maternity care, providing essential diagnostic insights.  

When reporting ultrasound procedures, it is crucial to adhere closely to maternity obstetrical care medical billing and coding guidelines. 

maternity obstetrical care medical billing, maternity obstetrical care, maternity obstetrics
maternity obstetrical care medical billing, maternity obstetrical care, maternity obstetrics

Documentation and Image Retention 

To comply with AMA CPT and ultrasound billing standards, every procedure must include:  

  • Written Reports: Providers must document detailed findings for each procedure. 
  • Image Storage: Retain images demonstrating relevant anatomy or pathology, ensuring they are accessible for review. While CPT guidelines do not specify the number of images or storage methods, the provider must note where these images and reports are stored. 

Using Modifiers for Complex Cases

For cases involving multiple fetuses or distinct procedures performed in a single encounter, appropriate modifiers must be applied. Incorrectly reported modifiers can lead to claim denials, so precision is crucial.  

Key Ultrasound CPT Codes 

Ensure your practice adheres to guidelines for reporting the following common ultrasound procedures: 

  • 76801–76810: maternal and fetal evaluation (transabdominal approach, by trimester) 
  • 76811–76812: above and detailed fetal anatomical evaluation 
  • 76813–76814: fetal nuchal translucency measurement 
  • 76815: limited trans-abdominal ultrasound study 
  • 76816: follow-up trans-abdominal ultrasound study 
  • 76817: trans-vaginal ultrasound study 
  • 76818–76819: fetal biophysical profile 
  • 59025: fetal non-stress test  

To avoid denials and ensure accurate reimbursement: 

  • Review parenthetical CPT guidelines for coding multiple gestations and combined procedures. 
  • Use modifiers accurately for distinct services during a single session. 

Trimesters of Pregnancy

For ICD-10-CM coding, include a code from Z3A.- to indicate the week of gestation:  

  • 1st Trimester: Less than 14 weeks 0 days. 
  • 2nd Trimester: 14 weeks 0 days to less than 28 weeks 0 days. 
  • 3rd Trimester: 28 weeks 0 days to delivery.  

For example, report a 15-week gestation with Z3A.15. 

maternity obstetrical care medical billing, maternity obstetrical care, maternity obstetrics

For ICD-10-CM reporting purposes, an additional code from category Z3A.- (weeks of gestation) should ALWAYS be reported to identify the specific week of pregnancy. (e.g., 15-week gestation is reported by Z3A.15). 

maternity obstetrical care medical billing, maternity obstetrical care, maternity obstetrics

Diagnosis Codes for Deliveries and Related Services

Accurate diagnosis coding is equally important for maternity billing. Follow these guidelines:  

  • Routine Prenatal Visits: Use a code from Z34.- as the first-listed diagnosis unless another medical condition affects the pregnancy. Avoid combining Z34.- with an O code. 
  • Outcome of Delivery: When a delivery occurs, include ICD-10-CM Z37.- to document the outcome. 
  • Normal Delivery (ICD-10-CM O80): only for full-term normal delivery and delivers a single, healthy infant. Additionally, there are no complications in the antepartum period, during the delivery, or in the postpartum period during the delivery encounter. 
  • If O80 is not appropriate, the primary diagnosis should reflect the main circumstances or complications of the delivery. 
  • If the patient is admitted with condition resulting in cesarean, then that is the primary diagnosis. 
  • If admitted for other reason, the admitting diagnosis is primary for admission and reason for cesarean linked to delivery. 
  • If multiple conditions prompted the admission, sequence the one most related to the delivery as the principal diagnosis.  

Diagnosing Cesarean Deliveries: 

  • If admitted for a condition resulting in a cesarean, that condition is the primary diagnosis. 
  • For other admissions, use the admitting diagnosis as primary, with the cesarean-related condition as secondary.  

Reporting Complications (O Codes): 

When a delivery involves complications, always report a code from ICD-10-CM Chapter 15. Include all monitored or treated conditions (e.g., gestational diabetes, pre-eclampsia, anemia, GBS).  

All conditions treated or monitored can be reported (e.g., gestation diabetes, pre-eclampsia, prior C-section, anemia, GBS, etc.) 

Common Modifiers used in Maternity Billing

  • Modifier 22: Increased procedural services: When the work required to provide a service is substantially greater than typically required.  
  • Modifier 24 – Unrelated Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional During a Postoperative Period. 
  • Modifier 25 – Significant, Separately Identifiable Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional on the Same Day of the Procedure or Other Service. 
  • Modifier 51 – Multiple procedures: When multiple procedures, other than E/M services, physical medicine and rehabilitation services or provision of supplies (e.g., vaccines), are performed at the same session by the same provider, the primary procedure or service may be reported as listed. 
  • Modifier 57 – Decision for Surgery. 
  • Modifier 78 – Unplanned Return to the Operating/Procedure Room by the Same Physician or Other Qualified Health Care Professional Following Initial Procedure for a Related Procedure During the Postoperative Period. 
  • Modifier 80 – Assistant Surgeon: Surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). 
  • Modifier 82 – Assistant Surgeon (when qualified resident surgeon not available): The unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). 
  • Modifiers 59 – Is used to identify procedures or services, other than E/M services, that are not normally reported together but are appropriate under the circumstances. An additional modifier used in place of Modifier 59 according to specific payer guidelines.   
  • Modifier XE – “Separate Encounter, a service that is distinct because it occurred during a separate encounter.” Only use XE to describe separate encounters on the same DOS 
  • Modifier XS – “Separate Structure, a service that is distinct because it was performed on a separate organ/structure.”  
  • Modifier XP – “Separate Practitioner, a service that is distinct because it was performed by a different practitioner.”  
  • Modifier XU – “Unusual Non-Overlapping Service, the use of a service that is distinct because it does not overlap usual components of the main service.”    

Do not use modifiers 59, XE, XS, XP, XU, and other NCCI PTP-associated modifiers to bypass an NCCI PTP edit unless the proper criteria for use of the modifiers are met. Medical documentation must support the use of the modifier.    

Depending on your state and insurance carrier (Medicaid), there may be additional modifiers necessary to report depending on the weeks of gestation in which the patient delivered. Before completing maternity obstetrical care billing and coding, always make sure that the latest OB guidelines are retrieved from the insurance carrier to avoid denials or delayed reimbursement.   

Finally, always be aware that individual insurance carriers provide additional information such as modifier use. 

Boost Your Billing Efficiency
Discover how robotic process automation can transform efficiency and revenue.

The Importance of the Global OB Package

Obstetric billing can be complex, so it’s important to follow the CPT guidelines, correctly append diagnoses, and ensure physician documentation of the antepartum, delivery, and postpartum care, and amend modifier(s)as needed.  

Pay special attention to the Global OB Package. The coder should have access to the entire medical record (initial visit, antepartum progress notes, hospital admission note, intrapartum notes, delivery report, and postpartum progress note) to review what should be coded outside the global package and what can be bundled in the Global Package. 

maternity obstetrical care medical billing, maternity obstetrical care, maternity obstetrics

Focus on Care, Let Neolytix Handle the Paperwork

Navigating the complexities of maternity billing shouldn’t burden your team. At Neolytix, we specialize in:  

  • Accurate OB/GYN and multi specialty billing and coding. 
  • Revenue cycle management and medical credentialing 
  • Medical coding audits for compliance and accuracy   

 

We also provide specialty-specific resources for Pain Management, Speech Therapy, Evaluation Management, and Psychotherapy to ensure your billing practices are optimized across the board.  

Access our Maternity Billing & Coding Guide for 2025 and explore guides for other specialties directly on our website. Let Neolytix handle the complexities of medical billing and coding so you can focus on delivering exceptional care to your patients.  

Take a Step Closer to Transforming Your Billing Operations.

FAQs on Maternity Obstetrical Care Billing

The CPT code for obstetric care includes comprehensive codes like 59400 for routine obstetric care including antepartum, vaginal delivery cpt code, and postpartum care cpt code. The 59510 CPT code is used for cesarean deliveries, while the CPT code for repeat cesarean section is the same but may include additional modifiers to indicate the repeated procedure. 

Obstetric care meaning encompasses antepartum care CPT codes, delivery, and postpartum care. Services include routine prenatal visits, labor and delivery management, and postnatal follow-up. Proper OB/GYN CPT codes should be used to bill these services accurately. 

Billing for an OB visit involves using the CPT code for OB visit such as 59425 CPT code description for antepartum care only (4-6 visits). Ensure all services are documented accurately. 

The CPT code for delivery varies depending on the type of delivery. The 59400 CPT code description is used for vaginal delivery, which includes routine obstetric care like antepartum care, delivery, and postpartum care. For cesarean delivery, the 59510 CPT code description covers routine obstetric care, including antepartum care, the CPT code for cesarean section, and postpartum care. Accurate use of these OB GYN CPT codes ensures comprehensive billing and proper reimbursement for delivery services. 

Basic emergency obstetric care includes procedures to handle common complications such as hemorrhage and sepsis during labor and delivery. It's essential to follow OB/GYN coding guidelines for accurate billing. This includes the appropriate use of pregnancy CPT codes and other relevant OB GYN CPT codes. 

OOPs stands for Out Of Pocket costs in medical billing, referring to the expenses patients must pay themselves as they are not covered by insurance. Understanding OB/GYN billing and coding guidelines can help minimize these unexpected costs for patients. 

The CPT code for first trimester services includes various codes for initial visits and routine checks within the first 14 weeks of pregnancy. These codes are part of the broader CPT code for pregnancy visits, ensuring comprehensive billing for early antepartum care. Other examples include the CPT code for prenatal care, which ensures that all routine examinations and necessary tests are properly documented and billed.  

The ICD-10 code for routine obstetric care is Z34.-, which should be the first-listed diagnosis unless other medical conditions affect the pregnancy. This code is used alongside ob gyn medical billing practices to ensure accurate reporting and compliance with OB/GYN coding guidelines. Proper use of this code is essential for documenting routine prenatal care and is an integral part of OB delivery CPT codes management. 

The CPT code for obstetrical ultrasound includes 76801–76817, depending on the type and timing of the ultrasound. These codes are critical in OB GYN billing to document prenatal imaging procedures.Proper use of these codes ensures compliance with OB GYN coding guidelines and supports the overall billing process for CPT code for labor and delivery. Accurate documentation with these codes helps in the efficient management of OB delivery CPT codes and enhances the overall effectiveness of OB/GYN medical billing practices. 

Pregnancy visits are billed using CPT code for prenatal visit, such as 59425 for 4-6 visits or 59426 for 7 or more visits. Accurate billing requires adherence to OB GYN billing and coding guidelines. 

The CPT code for C-section is 59510, which includes routine obstetric care including antepartum care, cesarean delivery, and postpartum care. 

By addressing these common questions and incorporating specific CPT codes and OB/GYN billing and coding guidelines, this FAQ section helps streamline the billing process and ensures compliance with current standards. 

Stay ahead of the curve & join our provider community to get updated on the latest industry trends.

Newsletter (Active)

This field is hidden when viewing the form
Homepage Asset Icon 16
Homepage Asset Icon 17
Form Image

Sign Up to Get Your
Maternity Care Fast Facts

Name(Required)
This field is hidden when viewing the form