What is Obstetrics/Gynecology?
It is a branch of medicine that specializes in the care of women during pregnancy and delivery and the diagnosis and treatment of illnesses of the female reproductive organs. It also focuses on other aspects of women’s health, such as menopause, hormonal issues, contraception (birth control), and infertility.
Obstetrics and Gynecology Coding Guidelines 2022
Maternity care services are as follows
- Antepartum care
- Delivery services
- Postpartum car
The two kinds of OB coding and billing criteria are listed below.
- Global OB Care
- Non-global obstetric care.
Global OB/GYN Care
Antepartum care, delivery services, and postpartum care are included in the entire obstetric care package. Report the Global OB package code when the same group physician and other health care provider supplies all components of the OB package.
CPT Codes For Global OB
CPT code 59400:
The American Medical Association’s Current Procedural Terminology (CPT®) code 59400 is a medical procedural code that falls under Vaginal Delivery, Antepartum, and Postpartum Care Procedures.
CPT code 59510:
This CPT code is used if you were the doctor who provided antepartum and postpartum treatment.
CPT code 59610:
The American Medical Association’s CPT code 59610 is a medical procedural code used for delivery procedures after previous cesarean delivery.
CPT code 59618:
This CPT code is a medical procedural code in the range used for delivery procedures after previous cesarean delivery.
Non-global obstetric care
Non-global OB care, also known as partial services, is maternity care that is not controlled by a single practitioner or group practice. Billing for non-global OB or partial care may occur if, and only if, the following conditions are met:
- A patient moves into or out of the care of a physician or group practice
- A patient is sent to another doctor during her pregnancy
- A patient is delivered by a physician or other health care worker who is not affiliated with her physician or group practice.
- A patient’s pregnancy is terminated or miscarried.
- During her pregnancy, a patient switches insurance companies.
1. Antepartum Care Only
For 1 to 3 visits: Make use of E/M office visit codes.
For 4 to 6 visits: Use CPT 59425-This code cannot be invoiced in connection with one to three office visits or conjunction with code 59426.
For 7 or more visits: CPT 59426 – Complete antepartum treatment is only available for one beneficiary pregnancy per physician.
2. Delivery Services Only
The CPT codes for delivery services are as follows:
CPT code 59409: The American Medical Association’s Current Procedural Terminology (CPT®) code 59409 is a medical procedural code that falls under Vaginal Delivery, Antepartum, and Postpartum Care Procedures.
CPT code 59514: The CPT code 59514 is a medical procedural code in the range used for Caesarean Delivery Procedures.
CPT code 59612: The CPT code 59612 is a medical procedural code in the Delivery Procedures After Previous Caesarean Delivery.
CPT code 59620: The CPT code 59620 is a medical procedural code in the Delivery Procedures After Previous Caesarean Delivery.
When there is a single gestation, the delivery only codes should be recorded by the same group physician.
The patient does not receive the entire OB package from the same physician or group practice.
Only the delivery part of maternity care is offered; another physician or group of physicians supplies postpartum care.
3. Delivery only, including Postpartum Care
If the same individual or group of physicians handled both birth and postpartum care, only a few CPT codes covered both services. The following are CPT-defined delivery and postpartum care.
CPT code 59410: Vaginal birth exclusively (with or without episiotomy and forceps); postpartum care included.
CPT code 59515: Caesarean delivery alone; postpartum care included.
CPT code 59614: Vaginal delivery exclusively, following prior cesarean delivery (with or without episiotomy and forceps); includes postpartum care.
CPT code 59622: Caesarean delivery only, after attempted vaginal delivery following cesarean delivery; includes postpartum care.
4. Postpartum Care Only
Only CPT-defined postpartum care is provided here.
CPT code 59430: This includes only postpartum care (separate procedure
Postpartum Care Services Include uncomplicated pregnancy-related outpatient appointments and contraception discussions.
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