OB/GYN Billing Best Practices

1. Verify Coverage for OB & GYN Services

✔ Check maternity, preventive, and surgical coverage
✔ Confirm if global OB care applies (prenatal, delivery, postpartum)
✔ Review frequency limits on annual well-woman exams and ultrasounds

2. Accurate Coding by Visit Type

✔ Use appropriate CPT codes for preventive vs. problem visits
✔ Link ICD-10 codes for pregnancy stages or gynecological conditions
✔ Apply global OB codes (e.g., 59400) for bundled maternity care

3. Track Global Billing Periods

✔ Monitor start-to-end dates for prenatal to postpartum care
✔ Separate unrelated visits from global package claims
✔ Log hospital and delivery details in patient records

4. Include Supporting Documentation

✔ Document trimester, EDD, and visit details for OB claims
✔ Record procedures like pap smears, biopsies, or ultrasounds
✔ Capture operative reports for surgeries and deliveries

5. Common Challenges & Fixes

ChallengeFix
Incorrect use of global vs. separate codesClarify billing rules per payer and visit type
Missed delivery detailsEnsure labor/delivery reports are added to the chart
Annual exam deniedAppend modifier (e.g., 25) when preventive overlaps with treatment
High denial rates for OB visitsReview maternity benefit coverage and document thoroughly
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