OB/GYN Coding: Tips and Tricks

The easiest tip or trick we could give you is to have our amazing Gables Medical Billing team help you run your revenue cycle management and destress your practice’s team. OB/GYN billing is difficult because there are so many nuances in the treatment and work that you do to ensure your patients are their healthiest. To begin you have to have deep knowledge and understanding of the coding and CPT (Current Procedural Terminology) codes. These “codes” are a number that corresponds to a medical service or procedure. In the Obstetrics world the codes come from the 56405 to 59899 range, there is the possibility of utilization of other codes, but that’s where you’ll usually see the bulk of your work. Here’s where the tips begin:

To begin you’ll want to understand the billing guidelines of each payer. Every payer is different and in their own unique way, their system causes different headaches. Like, did you know that Medicaid HMO plans will require certain sorts of claims with codes that are not the standard CPT?

Use more all-encompassing codes for maternity. This will help you bill more services without having to include separate codes for each service that you perform.

Remember that you should use separate evaluation and management codes. These codes are not necessarily tied to “maternity care”, they could be used more widely and simplify your coding.

You can also use, as mentioned above, the more “global” or “all-encompassing” codes, we’ve included a few below for obstetric services:

59400 is the code for vaginal delivery and the obstetric care that comes afterward. This includes antepartum and postpartum care.

59510 is the code for care from an obstetrician after a caesarian section, including antepartum and postpartum care.

59610 is the code for care from an obstetrician after a vaginal delivery, regardless of episiotomy, after a prior caesarian delivery, including antepartum and postpartum care.

59618 is the code for routine care from an obstetrician for a caesarian delivery following an attempt to deliver vaginally after prior caesarian delivery. This includes antepartum and postpartum care.

As far as gynecological tips and tricks, we have the following:

As far as well-woman visits the standard is to have a yearly check-up. This includes a general health screening and a cervical cancer screening. Well-woman visits are coded based on several factors, including the age of the female and whether they are a new patient or not. The codes range from 99395 to 99397 for your existing patients and 99385 to 99387 for new patients.

At any rate, and despite the codes, you need to use for existing or new patients the Gables Medical Billing team is ready to handle all of your practice’s claim submissions, follow-ups, appeals, and payment posting with the professionalism and dedication they deserve.