Obstetrics and Gynaecology is a broad and diverse branch of medicine, including surgery, management of the care of pregnant women, gynaecologic care, oncology, and primary health care for women.
Childbirth is a miracle for the very reason that the mother puts her own life on the line to bring forth her little one into the world. OB-GYN practitioners make this miracle possible through their flawless services
- OB is obstetrics, which deals with the maternity phase right from conception, labor, and childbirth to postpartum.
- GYN means gynecology, which is the diagnosis and treatment of the female reproductive system, which includes the vagina, uterus, ovaries, fallopian tubes, etc.
Global Codes for OB/GYN Billing
OB global codes include 59400, 59510, 59610 and 59618. These include all care from antepartum through delivery and postpartum care. 59400 – Routine obstetric care for vaginal delivery (with or without episiotomy and/or forceps), including antepartum and postpartum care.
The CPT code for Obstetrics & Gynaecology ranges from 56405 – 58999, including procedures done in the female genital system and maternity care & delivery
For billing purposes, the obstetric (OB) period begins on the date of the initial visit in which pregnancy was confirmed and extends through the end of the postpartum period (56 days after vaginal delivery and 90 days after C-section).
Antepartum care only codes’ should be billed when the practitioner or practitioners of the same group, will not be performing all 3 components of global OB care (more than 3 antepartum visits, delivery, and postpartum care). Only one antepartum care code is allowed to be billed per pregnancy.
- <3 antepartum visits are performed – bill appropriate E/M codes for the visits
- 4-6 antepartum visits – Bill 59425
- 7-14 antepartum visits – Bill 59426
- More than 14 antepartum visits due to complications of pregnancy – Bill 59426 and append the 22 modifier to indicated increased services.
Delivery begins on the date of initial hospitalization for delivery and extends through the date in which the member is released from the hospital. Hospital care, related to the delivery, is considered part of the delivery charge and is NOT considered part of postpartum care. If a C-section is performed, the reimbursement for the delivery only charge includes payment for the surgical procedure as well as the post-surgical care.
- Vaginal delivery only – bill 59409
- C-section delivery only – bill 59514
- VBAC delivery only – bill 59612
- C-section after attempted VBAC delivery only – bill 59620
- Delivery of multiples – bill appropriate delivery code (determined by the method of delivery of baby A), for 1 unit, and append 22 modifier. Attach documentation showing the method of delivery for each baby.
- Complicated delivery – bill appropriate delivery code and append the 22 modifier. Attach documentation describing delivery complications.
Postpartum care begins after the patient is discharged from the hospital stay for delivery and extends throughout the postpartum period (56 days for vaginal delivery and 90 days for cesarean delivery).
- Postpartum care only – bill 59430
When a provider performs the delivery and postpartum care and did NOT perform the antepartum care, the appropriate delivery and postpartum code should be billed.
- Vaginal delivery including postpartum – bill 59410
- C-section delivery including postpartum care – bill 59515
- Vaginal birth after cesarean delivery (VBAC) including postpartum care – bill 59614
- C-section after attempted VBAC including postpartum care – bill 59622