OB/GYN Billing Services

OB/GYN practices miss revenue primarily in three areas. First, unbundling high-risk antepartum care from the global package. When a pregnant patient develops gestational diabetes, preeclampsia, or another complication, the additional monitoring visits, non-stress tests, and ultrasounds beyond the standard prenatal schedule are separately billable — but only if coded correctly with the complication diagnosis as primary. Many practices include these in the global package, losing $200 to $500 per additional visit. Second, same-day OB + GYN coding. When a patient presents for a routine prenatal visit but also has a GYN concern (abnormal bleeding, pelvic pain, breast lump), the GYN evaluation is separately billable from the antepartum global with modifier 25. This adds $80 to $150 per encounter and occurs more frequently than practices realize. Third, postpartum visit coding. The postpartum visit is included in the global package, but complications discovered at the postpartum visit (wound complications, postpartum depression requiring treatment, new GYN conditions) can be billed separately. Additionally, contraceptive counseling (99401-99404) and IUD/implant insertion performed at the postpartum visit are separately billable from the global.