Specialized OB/GYN Billing Services

Our OB/GYN specialists meticulously manage the global obstetrical package from antepartum through postpartum care. We track antepartum visit counts to ensure proper code selection (59400 for vaginal delivery global, 59510 for cesarean global), apply modifiers when services fall outside the global package, and ensure accurate documentation supports the delivery method and any complications. We also handle the nuances of global package billing for multiple gestations and high-risk pregnancies.

When a well-woman visit includes evaluation of a new or existing problem, we ensure proper coding with modifier 25 appended to the preventive E/M code and a separate problem-oriented E/M service billed with a different diagnosis. Our coders verify documentation supports both components, navigate Medicare's NCD for screening pelvic exams, and ensure compliance with payer-specific preventive care copay/coinsurance rules.

We code gynecologic surgeries based on approach (vaginal, laparoscopic, abdominal, robotic), extent of procedure, and pathology. Our specialists are experienced with hysterectomy coding (58150-58294), coding for concomitant procedures, proper use of NCCI edits, and modifier application for multiple procedures. We also navigate the complexities of coding for endometrial ablation, pelvic organ prolapse repair, and incontinence procedures.

Our ultrasound coding covers the full spectrum of OB/GYN imaging. For obstetric ultrasound, we correctly distinguish between fetal anatomic surveys (76811-76812 for detailed, 76805-76806 for standard), limited studies (76815-76817), biophysical profiles (76818-76819), and Doppler studies (76820-76828). For gynecologic ultrasound, we code based on approach — transabdominal (76856), transvaginal (76830), or saline infusion sonohysterography (76831).

Yes. Infertility billing requires specialized knowledge of payer-specific coverage policies, many of which have limited or no infertility benefits. We handle diagnostic workup coding, ovulation induction monitoring, IUI (58322), and IVF cycle billing including oocyte retrieval (58970), embryo culture, and embryo transfer (58974). We track cycle limits, lifetime maximums, and medical necessity documentation requirements specific to each plan.