OB/GYN billing across obstetric global, surgical, and preventive revenue

OB/GYN runs three books: obstetric global packages, gynecologic surgery, and annual preventive. Each has distinct rules. We manage global billing without the timing errors that cost practices six figures a year.

Where ob/gyn practices lose revenue

We see the same patterns across ob/gyn groups. The leaks are specific, recurring, and fixable with coding discipline and payer-aware claim construction.

  1. Global obstetric package vs split billing (antepartum, delivery, postpartum)
  2. Multiple gestation and complicated delivery coding
  3. Well-woman exam vs problem-focused visit on same day
  4. IUD and contraceptive device billing (J codes, 58300)
  5. LEEP, colposcopy, and biopsy coding
CPT specimen sheet

High-volume OB/GYN codes we code and appeal

Not a complete list. A representative slice of the codes that drive revenue and denials for ob/gyn practices.

CodeDescriptionProfile
59400Obstetric global package, vaginal deliveryHigh volume
59510Obstetric global, cesareanModifier-sensitive
59430Postpartum care onlyDenial-prone
59025Fetal non-stress testHigh volume
58300IUD insertionModifier-sensitive
57454Colposcopy with biopsyDenial-prone
99381 to 99397Preventive E/M, age-appropriateHigh volume

How we run ob/gyn billing

Global OB tracking from first prenatal to 6-week postpartum. Split billing triggered automatically when patient transfers care or coverage changes mid-global. Problem plus preventive visit coded with modifier 25 when supported.

What the common denials look like and how we fix them

Pattern we see. Global OB split billing errors when coverage changes, modifier 25 denied on preventive plus problem visits, and IUD insertion denied without separate billing of the device (J7297, J7298, J7300).

How we fix it. Every denial is logged against its CARC/RARC code and routed to a coder who owns the appeal. We rebuild the claim with the documentation the payer is actually asking for, not a generic reconsideration letter. Recovery rate on appealable ob/gyn denials averages above 60 percent.

How do you handle coverage changes during pregnancy?
We split the global into antepartum, delivery, and postpartum and bill each to the active payer at the time of service. Without this tracking, practices lose thousands per mid-pregnancy coverage change.
Can you bill IUDs?
Yes. The device (J7297, J7298, J7300, J7301) and the insertion (58300) billed as separate line items. Most payers require both for full reimbursement.
Do you handle maternal-fetal medicine billing?
Yes. MFM consultations (99242 to 99245 or E/M with care coordination), fetal ultrasound (76801, 76811, 76816), and the high-risk pregnancy management codes with the prior auth workflow most commercial plans require.
Can you bill infertility procedures?
Infertility coverage varies by state and plan. We verify benefits upfront, bill diagnostic workup to medical, and bill treatment cycles to the self-pay or the mandated fertility benefit depending on coverage.
Start here

See what ob/gyn billing could actually look like.

A written 30-day diagnostic. Dollar figures against every finding. No obligation.

Call Get a free audit