OB/GYN Billing Services

OB/GYN billing is unusual because one patient can generate months of care under a single claim. Prenatal visits, delivery and postpartum care are often bundled into a global obstetric package. If a patient transfers out, delivers elsewhere or changes insurance mid-pregnancy, the claim has to be split correctly.

The same practice also bills well-woman exams, in-office procedures, device insertions and surgery. Each follows different rules. Westmont Revenue Partners connects OB/GYN practices with vetted medical billing experts who know these differences. If you are comparing an OB/GYN billing company, this page explains what the work involves and where claims tend to go wrong.

Who this is for

• Private OB/GYN practices and group practices
• Obstetricians, gynecologists, and nurse practitioners in women's health
• Practices that deliver at one or more hospitals
• Hospital-employed OB/GYN groups that want outside revenue cycle help
• Practices adding in-office procedures or ultrasound

What gets billed

• Global obstetric care (prenatal, delivery, postpartum)
• Delivery-only and postpartum-only services when care is split
• Cesarean delivery and vaginal birth after cesarean
• Annual well-woman and preventive exams
• Cervical cancer screening and colposcopy
• Intrauterine device insertion and removal, plus the device itself
• Hysteroscopy and endometrial sampling
• Office and obstetric ultrasound
• Gynecologic surgery such as hysterectomy and pelvic repair
• Problem visits for abnormal bleeding, pelvic pain and menopause

Commonly billed codes

Code	Type	What it covers
59400	CPT	Global care for a vaginal delivery, including prenatal and postpartum
59510	CPT	Global care for a cesarean delivery
59610	CPT	Global care for a vaginal birth after a prior cesarean
59409	CPT	Vaginal delivery only, when care is not global
59430	CPT	Postpartum care only
58300	CPT	Placing an intrauterine device
58301	CPT	Removing an intrauterine device
J7298	HCPCS	A hormonal intrauterine device supply
57454	CPT	Colposcopy of the cervix with biopsy and endocervical curettage
58558	CPT	Hysteroscopy with endometrial sampling or polyp removal
88175	CPT	Thin-layer Pap test with automated screening and manual rescreening or review
Z34.00	ICD-10-CM	Supervision of a normal first pregnancy, unspecified trimester

Note

Codes are examples for orientation, not a complete list, and do not guarantee coverage or payment. Always check current code sets and payer policy.

Billing challenges in OB/GYN

• Global package timing. A global claim usually cannot go out until delivery, which delays cash. Billers track each patient's course so prenatal visits are not billed twice and the package is submitted at the right time.
• Split or transferred care. When a patient joins late or leaves early, the practice may bill visits separately instead of the package. An experienced biller counts visits and checks payer rules before choosing the code.
• Insurance changes mid-pregnancy. Coverage can change between conception and delivery. Eligibility checks at each stage help decide which payer owns which part of the care.
• Same-day visits and procedures. A problem visit on the day of a procedure may need a modifier and clear documentation to be paid separately.
• Contraceptive device billing. The insertion, the device and the diagnosis must all be on the claim. Missing the supply code is a common lost-revenue issue.
• Ultrasound documentation. Payers expect specific elements for complete versus limited scans. Billers review notes and images before billing.
• Midwife and physician collaboration. When a midwife and a physician share a patient, who bills what depends on the payer. Billers confirm this up front.

How Westmont can help

• Match your practice with vetted billing experts experienced in OB/GYN
• End-to-end revenue cycle support, from eligibility to payment posting
• Denial management and appeals for obstetric and gynecologic claims
• Help with provider credentialing and payer enrollment
• Clear reporting so you can see where claims are held up

Frequently asked questions

When can we bill a global OB package?

Most payers expect the global code after delivery, once prenatal, delivery and postpartum care are complete. Some payers want itemized billing instead, especially for split care. Your biller should check each payer's policy and keep a visit count for every patient.

How do we bill when a patient delivers somewhere else?

If your practice only provided prenatal care, you usually bill the individual visits rather than the global code. Many payers set a visit threshold that decides this. Check each payer's rules, and keep notes showing which visits you performed.

Can we bill an IUD and the visit on the same day?

Often yes, if the visit was a separate, documented service beyond the device insertion. The device supply is billed on its own code. A modifier may be needed. Payer rules differ, so confirm before submitting.

What causes most OB/GYN denials?

Common causes include missing eligibility checks, duplicate prenatal billing, absent modifiers and incomplete ultrasound documentation. A billing partner who reviews claims before submission can catch many of these early.

Should we outsource OB/GYN billing?

It depends on your staff, volume and payer mix. Outsourcing can help if global packages and denials are taking too much front-office time. Westmont can connect you with billing experts so you can compare options.

Related billing services

• Maternal-Fetal Medicine
• Midwifery and Birth Centers
• Urogynecology
• Gynecologic Oncology
• Fertility