OB-GYN Billing

Billing built for OB-GYN practices, not generic medical.

Global maternity billing is a puzzle most billers get wrong. Preventive versus diagnostic visits, ultrasound frequency rules, and delivery bundling all trip up general medical billers. Our OB-GYN coders handle it every day. Same 4.99% flat rate. Same dedicated manager who knows the difference between 59400 and 59409.

OB-GYN Performance Active benchmark
95%
Clean claim rate
Industry avg: 79%
26 days
Days in AR
Industry avg: 44 days
3.1%
Denial rate
Industry avg: 8%
97%
Net collection
Industry avg: 87%
Common OB-GYN codes we handle daily
59400 59510 76805 58150 57454 99385 58558
0+
Years running
0+
U.S. states served
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Specialties billed
HIPAA
Compliant workflows
SOC 2
Type II aligned
Coding Coverage

OB-GYN CPT codes we handle every day.

Global maternity bundling, ultrasound frequency limits, and preventive-versus-diagnostic modifier rules. Our OB-GYN coders know the details.

59400

Global Vaginal Delivery

Antepartum, delivery, postpartum bundled. Watch for care that spans multiple providers or gets interrupted.

59510

Global Cesarean Delivery

Cesarean version of global obstetric care. Higher reimbursement, same bundling considerations.

76805

Obstetric Ultrasound

Complete transabdominal ultrasound, first trimester or later. Frequency limits vary by payer.

58150

Total Abdominal Hysterectomy

90-day global period. Modifier 22 for extended procedures. Concurrent procedures need modifier 51.

57454

Colposcopy with Biopsy

Biopsy and endocervical curettage. Watch for J-codes on any material sent to pathology.

99385

Preventive Visit, 18-39

Well-woman annual. Cannot be billed same day as problem-focused visit without modifier 25.

Top Denial Reasons

Where OB-GYN billing usually breaks.

Three patterns account for most denials in OB-GYN. Our specialized coders catch these before submission.

31%

Global Period Rules

Global maternity claims denied when antepartum visits were billed separately, or when care spans providers without proper handoff coding.

Our fix: Global maternity tracker per patient with antepartum visit logging. Correct unbundling only when patient transfers or delivery goes to another provider.
24%

Preventive vs Diagnostic

Well-woman visits denied when a problem is addressed in the same encounter without modifier 25 or clear documentation split.

Our fix: Documentation review checklist for every same-day preventive plus problem encounter. Modifier 25 applied only when appropriate.
17%

Ultrasound Prior Auth

OB ultrasounds beyond the initial denied for missing prior auth or exceeding payer frequency limits.

Our fix: Ultrasound frequency tracker per patient per pregnancy. Prior auth verified before every scan past the first.
Global Maternity Billing Workflow

How a pregnancy becomes clean revenue at every stage.

Global maternity is not one bill at the end. It’s a five-stage workflow that starts at the first prenatal visit and ends after the postpartum visit. Miss a step and revenue leaks.

1

Confirmation Visit

First OB visit billed separately (99201-99215). Global package starts only after confirmation.

Weeks 4-8
2

Antepartum Care

Routine prenatal visits logged into global package. Any high-risk visits coded separately with proper modifiers.

Weeks 8-40
3

Ultrasounds & Labs

Ultrasounds billed separately outside global (76805, 76811). Frequency tracked per patient per payer.

As indicated
4

Delivery

Vaginal (59400) or cesarean (59510) global code billed. If C-section after labor, modifier 22 for extended care.

Term
5

Postpartum Complete

Global package closed at 6-week postpartum visit. Any complications billed separately with proper diagnosis codes.

6 weeks post

Patient transfers happen. When care moves mid-pregnancy or a delivery goes to another provider, we unbundle correctly using 59425, 59426, or the delivery-only codes. No revenue lost, no double billing.

Compliance & Regulatory

OB-GYN-specific rules we track for you.

Global maternity rules, Medicaid state variations, and preventive coverage under the ACA all evolve. We track updates so your practice stays clean.

Global maternity rules

Payer-specific antepartum visit thresholds tracked

Most payers require 13+ visits for full global (59400). Fewer visits mean itemized billing (59425 or 59426). Rules vary by payer and state Medicaid. We maintain a payer rulebook so every claim is right.

Ultrasound frequency limits

OB ultrasound coverage rules by payer maintained

Commercial payers typically cover 3 routine OB ultrasounds. Additional scans need medical necessity documentation and often prior auth. We track allowed frequency per patient per payer.

ACA preventive coverage

Well-woman and preventive screenings billed correctly

ACA requires zero-cost preventive care for well-woman visits, contraception, and specific screenings. Miscoded and it bills as diagnostic, patient gets a bill, complaints follow. We keep the split clean.

Medicaid state variations

State-specific Medicaid maternity rules tracked

Medicaid maternity rules vary dramatically by state. Some states carve out specific services, some require CPS reporting for certain diagnoses. We keep state-specific rulebooks current across all 20+ states we serve.

What We Handle

Full-service OB-GYN billing.

Everything an OB-GYN practice needs, from global maternity packages to gynecological surgeries and well-woman preventive care.

Global Maternity Billing

Antepartum, delivery, postpartum bundled correctly. Unbundled when clinically appropriate.

Obstetric Ultrasound

Frequency tracked per patient. Prior auth verified before every scan past the first.

Gynecological Surgery

Hysterectomy, myomectomy, cystoscopy. Modifier 22 and 51 applied correctly.

Well-Woman Preventive

ACA-covered preventive services billed correctly with no unexpected patient charges.

Fertility & MFM

Maternal-fetal medicine consults, high-risk OB, and infertility diagnostics coded correctly.

Dedicated Manager

Same person answers when you have global maternity questions or need an appeal filed.

$54K
Additional monthly revenue captured
Ultrasound + preventive coding fixes
“We’re a five-provider OB-GYN group and our previous biller kept unbundling global maternity when they shouldn’t have. On the flip side, they missed billing our ultrasounds separately when they should have. CureMed fixed both in the first month. Fifty-four thousand a month back on the books.”
OM
Office ManagerOB-GYN Group, Colorado
Frequently Asked Questions

Common questions about OB-GYN billing.

What is OB-GYN billing?

OB-GYN billing covers claims for obstetric and gynecological services including global maternity care, deliveries, gynecological surgeries, well-woman visits, and obstetric ultrasound. It requires deep knowledge of global maternity packages, preventive versus diagnostic coding, and payer-specific ultrasound rules.

What are the most common OB-GYN CPT codes?

Common OB-GYN CPT codes include 59400 (global obstetric care with vaginal delivery), 59510 (cesarean delivery), 76805 (obstetric ultrasound), 58150 (total hysterectomy), 57454 (colposcopy), and 99385/99395 (preventive visits).

Why do OB-GYN claims get denied?

Top reasons include global period rule violations (31%), preventive versus diagnostic coding errors (24%), and prior authorization issues for ultrasounds (17%). Global maternity unbundling is a particularly common issue that leaves revenue on the table.

Do you handle Medicaid maternity billing?

Yes. Medicaid maternity rules vary dramatically by state. We maintain state-specific rulebooks across all 20+ states we serve, so your Medicaid claims align with each state’s specific requirements.

How do you handle patient transfers mid-pregnancy?

When care transfers to or from your practice mid-pregnancy, we unbundle correctly using 59425 (antepartum care only, 4-6 visits), 59426 (7+ visits), or delivery-only codes. Your practice bills only for what you provided, no revenue lost, no double billing.

Ready for billing that actually speaks OB-GYN?

Send us three months of your maternity claims and denials. We’ll deliver a free OB-GYN-specific audit within a week showing exactly where your revenue is slipping.