OB/GYN billing runs two different systems inside one specialty. Obstetrics is mostly bundled: routine pregnancy care, delivery, and postpartum care are billed as a single global package. Gynecology is mostly fee for service: each visit, procedure, and surgery is billed and paid individually. The denials in this specialty usually come from mixing the two up, billing a global code when care was split between providers, or letting separately payable services disappear inside the bundle.
MedPlus RCM provides medical billing, coding, credentialing, and denial management for obstetrics and gynecology practices, built around the global maternity package and the gynecologic procedure rules that sit alongside it.

Obstetrics & Gynecology billing challenges

The global obstetric package bundles routine antepartum care, delivery, and postpartum care into one code when a single physician or group manages the whole episode. The commonly used global codes are 59400 for routine care with vaginal delivery, 59510 for cesarean delivery, 59610 for vaginal birth after a previous cesarean, and 59618 for cesarean after an attempted vaginal birth after cesarean. The package generally covers around 13 antepartum visits, the delivery, and postpartum care through about six weeks after delivery. Billing a global code when another physician handled part of the pregnancy is one of the fastest ways to trigger a rejection.
Not every service during pregnancy belongs in the bundle, and this is where revenue is most often lost. High risk pregnancy complications, diagnostic procedures beyond routine ultrasounds, and non-stress tests or biophysical profiles are commonly billable separately when documentation supports them. Transfer of care is the other major exception: when a patient changes providers mid-pregnancy, or enters care late, the phases are billed with component codes instead of a global code. Antepartum care only is billed with 59425 for 4 to 6 visits or 59426 for 7 or more visits, postpartum care only with 59430, and when fewer than 4 antepartum visits occur, individual evaluation and management codes are used instead. Problem visits unrelated to routine pregnancy management can also be billed separately when they carry a different diagnosis, though payer rules on this vary and must be checked per payer.
Gynecology coding follows standard surgical rules, including global periods for procedures, modifiers for increased procedural service when documentation justifies substantially greater work, and separate handling of preventive well woman visits versus problem visits on the same day. Payer maternity policies also vary, and some payers are moving away from bundled maternity billing toward itemized billing for antepartum visits, so the billing method must be confirmed per payer rather than assumed.

What MedPlus RCM handles for obstetrics & gynecology practices

  • End-to-end medical billing. Charge entry, claim scrubbing, submission, payment posting, and patient billing, the full cycle.
  • Medical coding. Certified coders assign current ICD-10, CPT, and HCPCS codes matched to your documentation and specialty.
  • Provider credentialing and enrollment. End-to-end enrollment with commercial payers and Medicare, plus re-credentialing maintenance.
  • Denial management and recovery. Every denial investigated to root cause, corrected, and appealed with documentation.
  • A/R recovery. Aged and outstanding balances audited and pursued, including balances already written off where the appeal window is still open.
  • Financial reporting. Clean claim rates, collections, denial patterns, and A/R aging visible by payer and provider.
    We serve obstetrics and gynecology practices nationwide, including solo practices, group practices, and hospital affiliated clinics, across prenatal care, high risk pregnancy, gynecologic surgery, and preventive women’s health.

Results obstetrics & gynecology practices can check

MedPlus RCM maintains a 99% clean claim rate and keeps client accounts receivable under 30 days. Pricing is a performance-based percentage of successfully collected revenue: if you don’t get paid, we don’t get paid. We are 100% HIPAA compliant, and onboarding takes 2 to 4 weeks depending on practice size, with no disruption to your daily cash flow.

Frequently asked questions

What is the global obstetric package?
It bundles routine antepartum care, delivery, and postpartum care into a single code when one physician or group manages the entire episode. Code selection depends on delivery type and on whether there was a prior cesarean.
When is antepartum care billed separately?
When the same provider does not deliver the baby, when a patient transfers mid-pregnancy, or when care is partial. Component codes cover 4 to 6 visits or 7 or more visits, and postpartum care alone has its own code.
What services fall outside the global package?
Complications of pregnancy, diagnostic procedures beyond routine ultrasounds, non-stress tests, and problem visits unrelated to routine pregnancy management are commonly billed separately, subject to payer rules and documentation.
How are preventive and problem visits handled together?
A preventive well woman visit and a problem oriented visit on the same day are distinct services. The problem visit must be documented as a significant, separately identifiable service to be paid alongside the preventive visit.
Do all payers use the global maternity model?
No. Payer maternity policies vary, and some payers are shifting toward itemized billing for antepartum visits. We confirm each payer’s method before claims go out.

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