Expert Obstetrics & Gynecology Billing Service

OB/GYN Medical Billing

We specialize in providing comprehensive ob/gyn medical billing services that allow you to focus on what matters most – your patients. Our expert team understands the unique challenges and intricacies of dermatology billing and is committed to improving your revenue cycle while ensuring compliance and accuracy in every step.

Common OB/GYN CPT Codes

Below are some commonly used CPT codes outside of the normal evaluation and management codes for OB/GYN:

Preventive Services

  • 99381-99397 - Preventive visits (well-woman exams, annual gynecologic exams, etc.)

    • 99381 - Initial comprehensive preventive evaluation and management, infant

    • 99382 - Initial comprehensive preventive evaluation and management, child 1-4 years

    • 99383 - Initial comprehensive preventive evaluation and management, child 5-11 years

    • 99384 - Initial comprehensive preventive evaluation and management, adolescent 12-17 years

    • 99385 - Initial comprehensive preventive evaluation and management, adult 18-39 years

    • 99386 - Initial comprehensive preventive evaluation and management, adult 40-64 years

    • 99387 - Initial comprehensive preventive evaluation and management, adult 65+ years

    • 99391-99395 - Periodic comprehensive preventive evaluation (established patient)

    • 99396 - Preventive visit for adults 40-64 years (established patient)

    • 99397 - Preventive visit for adults 65+ years (established patient)

Pregnancy & Prenatal Care

  • 59400 - Routine obstetric care including antepartum care, delivery, and postpartum care

  • 59409 - Routine obstetric care (antepartum care only)

  • 59410 - Delivery only (including cesarean delivery)

  • 59430 - Postpartum care (usually 6 weeks after delivery)

    Antepartum Visits (CPT codes for prenatal visits)

    • 99201-99215 (based on time and complexity of the visit)

  • 59610 - Vaginal delivery (with or without episiotomy) and postpartum care

  • 59612 - Cesarean delivery and postpartum care

Gynecologic Procedures

  • 58100 - Total abdominal hysterectomy

  • 58110 - Total abdominal hysterectomy with bilateral salpingo-oophorectomy

  • 58541 - Laparoscopic assisted vaginal hysterectomy

  • 58662 - Laparoscopy, surgical, with removal of ovaries

  • 57500 - Colposcopy of the cervix

  • 57505 - Colposcopy with biopsy of cervix

  • 58120 - Dilation and curettage (D&C)

  • 58300 - Insertion of intrauterine device (IUD)

  • 58301 - Removal of IUD

  • 58340 - Endometrial biopsy

Contraception Services

  • 11981 - Insertion, non-biodegradable contraceptive device (e.g., IUD)

  • 11982 - Removal of non-biodegradable contraceptive device (e.g., IUD)

  • 11983 - Removal and reinsertion of non-biodegradable contraceptive device (e.g., IUD)

Ultrasounds

  • 76830 - Transabdominal ultrasound, pelvic

  • 76831 - Transvaginal ultrasound, pelvic

  • 76856 - Obstetric ultrasound, first trimester

  • 76857 - Obstetric ultrasound, second trimester

  • 76858 - Obstetric ultrasound, third trimester

Other Gynecological Services

  • 99241-99245 - Office consultation (used when a physician is consulting for a specific case)

    • 99241 - Consultation, typically 15 minutes

    • 99242 - Consultation, typically 30 minutes

    • 99243 - Consultation, typically 40 minutes

    • 99244 - Consultation, typically 60 minutes

    • 99245 - Consultation, typically 80 minutes

Hormonal Therapy and Management

  • S9145 - Hormonal therapy management (e.g., for menopause)

  • J9202 - Injectable contraceptive therapy (e.g., Depo-Provera)

OB/GYN Medical Billing Best Practices

To ensure accurate and efficient billing, keep the following in mind:

  • Accurate Diagnosis Codes (ICD-10): Make sure to match the diagnosis code with the correct treatment.

  • Thorough Documentation: Ensure all patient interactions and treatments are thoroughly documented to support the codes submitted.

  • Payer Requirements: Different insurers may have specific rules for submitting claims. Always confirm payer-specific requirements to reduce the chance of denials.

  • Timely Filing: Submit claims as soon as possible to avoid any issues with claim acceptance and reimbursement.

Insurance Coverage and Reimbursement

OB/GYN are typically covered by most major insurance plans, including Medicaid, Medicare, and private insurers. However, reimbursement rates and coverage may vary based on:

  • The specific condition being treated

  • The patient's insurance plan

  • Whether the service is provided in-network or out-of-network It’s important to verify insurance coverage before providing treatment to ensure that services will be covered and that the correct billing codes are used.

Our Denials and Appeals Process

Medical claim denials are a common challenge in a OB/GYN practice. Our process:

  • Understanding the Denial Reason: Denials could be due to incorrect coding, insufficient documentation, or missing information. We thoroughly review the insurance company’s reason for denial and address it appropriately through various modes of response.

  • Appeal Process: If the claim is denied based on coverage or medical necessity, an appeal may be necessary. We review the insurance company’s appeal process and act quickly to submit it and reduce potential delays or timely submissions.

How we can help:

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    Comprehensive coding and claim submission

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    Insurance verification and prior authorization

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    Denial management and appeals

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    Contracting and Credentialing

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    Patient statements and collections

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    We specialize in ensuring your practice receives timely reimbursements while remaining fully compliant with industry standards and payer requirements

✺ Frequently asked questions ✺

  • We offer full-service medical billing, including coding, claim submission, insurance verification, patient billing, accounts receivable management, and denial management. We also assist with prior authorizations and appeals to ensure timely reimbursement

  • We have over 20 years of billing in all the specialties we have listed on our site!

  • Yes! All our billers are experts in the field. With many years of experience and we ensure to only assign the best biller for your specialty. We undergo quarterly trainings and are all certified!

  • We only use your medical billing software for complete transparency in our performance and to safeguard your practice with ethical and accurate standards.

  • We provide regular updates through email or phone calls to keep you informed on your billing status. Additionally, we use an online chat system such as Google or Teams for daily needs. We also schedule monthly calls, if needed!

  • Our onboarding process is simple and efficient. After an initial consultation, we gather necessary documents, set up your accounts in your system and portals. We aim to have everything up and running within 1-2 weeks.

  • We specialize in personalized service for each client, ensuring that your practice’s unique needs are met. Our team consists of highly trained professionals with expertise in a variety of specialties, and we offer a high level of transparency and communication. We work to maximize your revenue while ensuring accuracy and compliance.

  • Our team regularly attends continuing education courses, webinars, and conferences. We also have access to coding and regulatory updates from organizations like the American Health Information Management Association (AHIMA) and the American Academy of Professional Coders (AAPC).

  • We offer a transparent pricing model, with fees based on a percentage of collections. The exact percentage depends on the volume of claims and the complexity of your practice’s billing. We can provide a customized quote based on your needs.

  • We have a dedicated team that handles claim denials and rejections. When a claim is denied, we review the reason, correct any errors, and resubmit the claim. If necessary, we also handle the appeals process to ensure that your practice receives the reimbursement it's entitled to.

  • We are fully HIPAA-compliant and follow all federal and state regulations regarding patient data privacy. Our staff undergoes regular training on HIPAA standards, and we use secure systems to manage and transmit patient information.

  • Yes, we offer coding and billing audits to ensure that all your claims are submitted accurately and in compliance with industry regulations. Our audits help identify any discrepancies or potential risks, so you can address them proactively.

  • Based on the Tier plan you select, we offer patient support services for billing inquiries, ensuring that patients have a clear understanding of their charges. Our customer service team is available to answer any questions patients may have regarding their statements, insurance coverage, or payment plans.

  • Yes, we provide regular reports on your practice’s financial performance, including revenue cycles, collections, and any outstanding claims. You will have access to real-time data and in-depth analysis to help you make informed decisions about your practice.

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