Medical Billing for OB/GYN Practices

OB/GYN Billing That Pays What You Earn

OB/GYN billing is among the most complex in medicine: global obstetric packages, antepartum visit counting, delivery coding distinctions, and gynecologic procedure bundling all create significant denial risk. The transition from antepartum care through delivery and postpartum creates gaps that inexperienced billers routinely miss. 360Solutions assigns OB/GYN-specialised coders who manage global maternity packages, split-care billing, and gynecologic procedure modifiers with precision.

28%
avg OB/GYN revenue lost to global package errors
$650
avg revenue recovered per split-care obstetric case
48h
delivery claim submission turnaround
OB/GYN Billing Challenges
Where practices lose the most revenue:
Global OB Package Complexity
Delivery Code Selection
Gynecologic Procedure Bundling
Ultrasound & Imaging Splits
OB/GYN Billing Challenges

Where OB/GYN Practices Lose Revenue

These are the coding and billing pitfalls that cost ob/gyn practices the most — and where our specialised billers add the most value.

Global OB Package Complexity

The global obstetric package (59400/59510/59610/59618) bundles antepartum visits, delivery, and postpartum care. Counting antepartum visits correctly — and identifying when split-care billing applies — requires specialist knowledge that generalist billers lack.

Delivery Code Selection

Vaginal vs. cesarean, with/without antepartum care, attempted VBAC — each has its own code. Choosing the wrong delivery code results in underpayment, overpayment, or post-payment audit. Our coders verify delivery records before coding.

Gynecologic Procedure Bundling

Hysteroscopy, colposcopy, LEEP, and endometrial biopsy face aggressive payer bundling rules. We apply correct modifiers and unbundle legitimately separate services with supporting documentation.

Ultrasound & Imaging Splits

OB ultrasounds (76801–76828) require correct trimester coding, professional vs. technical component splits for hospital-based providers, and prior auth tracking. Errors here are among the most common OB denial triggers.

Coding Intelligence

High-Risk CPT Groups

Code ranges payers audit most aggressively in OB/GYN.

59400 / 59510
Routine vaginal / cesarean delivery — global antepartum + delivery + postpartum
59610 / 59618
VBAC delivery — attempted vs. successful, with/without antepartum
58150–58294
Hysterectomy procedures — abdominal, vaginal, laparoscopic variants
57454 / 57460
Colposcopy — with biopsy, with LEEP — endocervical curettage add-ons
76801–76828
OB ultrasound — by trimester, standard vs. detailed, fetal biophysical
Denial Intelligence

Common Denial Patterns

Knowing these before submission is the difference between a 60% and a 96% first-pass rate.

Antepartum visit count incorrect causing global package mismatch

Delivery code selected does not match operative note (vaginal vs. C-section)

Ultrasound billed globally when provider only performed professional component

Gynecologic procedure bundled with E&M on same date without modifier -25

Missing prior auth for elective cesarean or advanced ultrasound imaging

Free Denial Audit

Send us your last 90 days of remittance data — we'll identify your top 3 fixable denial sources at no cost.

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Our Process

How 360Solutions Works for OB/GYN Practices

01

Free 2-Week Billing Audit

We review your last 90 days: denial breakdown by category, AR aging by payer, charge lag, collection rate, and any recurring coding issues specific to your specialty. No commitment required.

02

Specialty Coder Assignment

You are paired with a coder trained specifically in ob/gyn coding. They learn your providers, your documentation patterns, and your payer mix before touching a claim.

03

Parallel Billing Transition

We run alongside your current billing for 10–14 days with zero cash flow disruption. Claims keep moving during the transition. Your account manager provides daily status updates.

04

Live KPI Dashboard

Real-time visibility into billed, paid, denied, AR aging, and collection rate — segmented by provider and payer. No black box, no month-end surprises.

05

Weekly Account Manager Call

Every week your dedicated account manager walks through last week's KPIs, denial trends, and any action items. Critical issues are escalated the same day — not at the next scheduled call.

OB/GYN Billing FAQ

Questions From OB/GYN Practices

Split-care billing (e.g., 59425/59426 for antepartum only) applies when care is divided between providers. We identify these scenarios at charge entry, count antepartum visits accurately, and bill each provider's component separately to avoid global package errors.
Yes. We maintain separate coding workflows for OB global packages and GYN procedure billing, applying the correct code sets, modifiers, and documentation standards for each service type.
We maintain payer-specific prior auth requirements, submit requests proactively at the start of pregnancy, and track approvals through delivery. Auth failures are among the top OB denial causes — our proactive tracking prevents them.
Yes. We handle billing under CNM NPIs with correct credential verification at each payer, apply incident-to rules where applicable, and manage the Medicare 85% reimbursement rate for non-physician practitioners.
Ready to Fix Your OB/GYN Billing?

Start With a Free,
No-Obligation Audit

Two weeks, no contract. A certified ob/gyn billing specialist reviews your claims, denial patterns, and AR — and shows you exactly what is recoverable.