Skip to content 
Obstetrics & Gynecology (OB/GYN) Billing Services
OBGYN billing presents unique challenges due to bundled maternity care, surgical procedures, diagnostic services, and frequent updates to CPT and ICD-10 codes. Inaccurate coding or missed payer-specific requirements often result in delayed reimbursements, denials, or underpayments. Effective billing in this specialty requires both up-to-date knowledge of coding guidelines and precise revenue cycle management.
With a team experienced in women’s health billing and the use of advanced technology, MZ Medical Billing delivers accurate, compliant, and reliable OBGYN billing solutions that help practices maintain financial stability while improving efficiency.
Start Improving Your OB/GYN Reimbursements
Please fill out the form with your details and we'll be in touch shortly to discuss your needs.
What Makes OB-GYN Medical Billing Challenging?
OB-GYN medical billing requires exceptional accuracy because even small errors can delay claims, reduce reimbursement, and distort a clinic’s financial performance. On average, OB-GYN practices lose nearly 10–15% of potential revenue each year due to coding errors, denials, and underpayments. Below are the main reasons billing for women’s health services is uniquely complex:
Keeping Up with CPT & ICD-10 Codes
OB-GYN billing involves a large number of codes for maternity, surgical, diagnostic, and preventive services. CPT and ICD-10 codes are updated frequently, and pregnancy coding requires trimester-specific documentation. A single mistake can result in denials and weeks of payment delays.
Global Maternity Billing Rules
Many insurers bundle antepartum, delivery, and postpartum services into global maternity packages (e.g., CPT 59400, 59510, 59618). If visits outside the package are missed, or the wrong global code is billed, practices lose revenue.
Modifier & Multi-Procedure Complexity
OB-GYN care often involves multiple procedures in a single visit, requiring correct use of modifiers (24, 25, 51, 59). Failure to apply modifiers properly can lead to underpayments or claim rejections.
Shortage of Skilled OB-GYN Billers
Trained professionals familiar with OB-GYN billing, global maternity packages, and ICD-10 coding are in short supply. This shortage makes it harder for practices to manage billing in-house.
Difficult Claim Appeals & Denials
When insurers deny claims—especially for ultrasounds, labs, or postpartum visits—the appeals process is often unclear and time-consuming. Without strong denial management, practices leave money on the table.
Dealing with Underpaying Insurers
Some insurers underpay for services, and smaller or regional payers can be especially difficult to collect from. Following up on these underpayments requires additional time and expertise.
Audit & Compliance Risks
Because maternity care is high-cost, OB-GYN practices face more frequent payer audits. Any compliance gaps in coding or documentation can trigger revenue loss or penalties.
These challenges, combined with evolving payer rules, make OB-GYN billing one of the most complex areas in medical billing. Many practices overcome these obstacles by outsourcing their billing to specialized professionals, reducing errors, improving reimbursements, and ensuring financial stability.
Obstetrics & Gynecology (OBGYN) Billing Services
MZ Billing’s OB/GYN Billing Service helps obstetricians and gynecologists manage complex billing and collections with accuracy and efficiency.
From global maternity packages to surgical procedures and diagnostic services, our team handles coding, claim submission, and reimbursement tracking with precision.
With 24/7 access to financial reports, electronic claims processing, and ongoing support to stay current with CPT and ICD-10 updates, we provide a reliable revenue cycle solution that allows OB/GYN providers to focus on patient care.
Medical Billing
We manage the entire billing process for Obstetrics & Gynecology (OBGYN) practices, with accurate claim submission and timely payment processing.
Medical Coding
Our experts apply the correct CPT and ICD codes for Obstetrics & Gynecology (OB/GYN) Practices to prevent rejections and maximize reimbursements.
Provider Credentialing
We help Obstetrics & Gynecology (OB/GYN) practices with CAQH setup, payer enrollment, and credentialing to expand network participation and improve patient access.
Practice Audit
Our team conducts billing audits to identify errors, improve compliance, and keep your billing process aligned with industry standards.
Revenue Cycle Management
We manage your revenue cycle from start to finish, supporting efficient cash flow and reducing payment delays.
Insurance Verification
We verify patients’ insurance coverage and benefits to provide accurate cost estimates for Obstetrics & Gynecology (OBGYN) Practices.
Prior Authorization
We handle prior authorizations for Obstetrics & Gynecology (OBGYN) practices, reducing delays and helping treatments get approved.
Denial Management
Our specialists identify the reasons for denials, correct issues, and resubmit claims to secure payments promptly.
Payment Posting
We carefully post payments to maintain accurate financial records and track reimbursements for Obstetrics & Gynecology (OB/GYN) Practices.
AR Recovery
Our AR recovery services focus on collecting outstanding payments effectively, improving your practice’s financial performance.
Telehealth Billing
We manage telehealth billing for Obstetrics & Gynecology (OB/GYN) practices, including compliant coding, accurate claim submission, and reimbursement tracking for virtual visits.
Healthcare Digital Marketing/SEO
We assist Obstetrics & Gynecology (OB/GYN) Practices in building an online presence with effective digital marketing and SEO strategies to attract more patients.
Key CPT Codes in OBGYN Medical Billing
Maternity & Delivery Global Packages
59400 – Vaginal delivery with routine antepartum and postpartum care
59510 – Cesarean delivery with routine antepartum and postpartum care
59610 – Vaginal delivery after previous cesarean (VBAC) with routine antepartum and postpartum care
59618 – Cesarean delivery following attempted vaginal delivery, including antepartum and postpartum care
Antepartum & Postpartum Care (when billed separately)
59425 – 4–6 antepartum visits
59426 – 7 or more antepartum visits
59430 – Postpartum care only
Gynecological Procedures & Surgeries
58150 – Total abdominal hysterectomy (TAH)
58558 – Hysteroscopy with biopsy of endometrium and/or polypectomy
57454 – Colposcopy with biopsy(s) of cervix and endocervical curettage
57522 – Conization of cervix, with or without fulguration
Diagnostic & Imaging Services
76801 – Obstetric ultrasound, first trimester, complete
76805 – Obstetric ultrasound, after first trimester, complete
88142 – Cytopathology, cervical or vaginal (Pap smear)
Key ICD-10 Codes in OBGYN Billing
Pregnancy & Delivery
O09.0–O09.9 – Supervision of high-risk pregnancy (different trimesters)
O80 – Encounter for full-term uncomplicated delivery
O82 – Encounter for cesarean delivery
O34.2 – Maternal care for scar from previous cesarean delivery
Gynecological Conditions
N80.0 – Endometriosis of uterus
N92.1 – Excessive and frequent menstruation
N85.0 – Endometrial hyperplasia
N97.0 – Female infertility due to anovulation
Preventive & Routine Care
Z01.411 – Gynecological exam with abnormal findings
Z01.419 – Gynecological exam without abnormal findings
Z12.4 – Screening for malignant neoplasm of cervix
Z34.0–Z34.9 – Supervision of normal pregnancy (varies by trimester and parity)
Common Modifiers in OBGYN Billing
Correct use of modifiers is essential in OB/GYN billing to avoid denials, underpayments, or bundling errors. Some of the most frequently used include:
Modifier 24 – Unrelated evaluation and management (E/M) service by the same physician during the postpartum or global maternity period.
Modifier 25 – Significant, separately identifiable E/M service performed on the same day as another procedure.
Modifier 26 – Professional component (used when only the physician’s work is billed, e.g., reading an ultrasound).
Modifier 50 – Bilateral procedure.
Modifier 51 – Multiple procedures, same session.
Modifier 52 – Reduced services (e.g., partial hysterectomy).
Modifier 59 – Distinct procedural service (used to bypass bundling edits).
Modifier 76 – Repeat procedure by the same physician.
Modifier 77 – Repeat procedure by another physician.
Modifier 79 – Unrelated procedure or service during the postpartum/global period.
Modifier 80 – Assistant surgeon.
Modifier 95 – Telehealth service (synchronous, real-time audio and video).
Modifier GT – Telehealth via interactive audio and video (used by some payers instead of 95).
OBGYN Billing & RCM Services for Providers Across All 50 States
MZ Medical Billing delivers expert Obstetrics & Gynecology (OB/GYN) billing and Revenue Cycle Management (RCM) services for providers in all 50 states. We help reduce claim denials, manage complex coding for maternity, surgical, and diagnostic services, and accelerate payments while keeping costs affordable. Acting as an extension of your team, our experienced OB/GYN billers handle accurate CPT and ICD-10 coding, clean claim submissions, and provide dedicated support, so you can focus on patient care instead of navigating the complexities of medical billing and insurance.
Medical Billing Services for OB/GYN and Other Specialties
Our experienced billers provide accurate, compliant, and efficient billing solutions for Obstetrics & Gynecology (OB/GYN) practices as well as a wide range of healthcare specialties. We deliver specialty-specific CPT and ICD-10 coding, streamlined claim submission, and revenue cycle management for ABA therapy, speech therapy, occupational therapy, physical therapy, mental health, family medicine, cardiology, dermatology, orthopedics, and women’s health services.
Benefits of Our (OB/GYN) Billing Services
Certified Coders: Our AAPC-certified specialists have deep expertise in OB/GYN coding, including global maternity packages, surgical procedures, E/M levels, and modifier use.
Risk Adjustment & Coding Audits: We follow the latest CPT, ICD-10, and payer-specific guidelines to detect errors, reduce denials, and keep your practice audit-ready.
Advanced Technology: Using tools like EHRAI-powered analysis, we identify causes of non-payment, resolve aged accounts, and monitor claim trends to improve reimbursement.
Denial Management: We track, appeal, and resolve denied claims promptly to protect your revenue and prevent recurring payment issues.
Telehealth & Virtual Visit Billing: We handle coding and claims for telehealth services, including modifiers and payer-specific requirements, to ensure proper reimbursement.
Compliance Monitoring: Our team stays updated on regulatory changes, payer rules, and documentation requirements to minimize risk and maintain revenue integrity.
MZ Medical Billing can handle every OBGYN practice Management Software:
Streamline Your OB/GYN Billing Today!
Managing OB/GYN billing can be complex and time-consuming. By choosing MZ Billing, your practice can focus on patient care while we handle coding, claim submission, denial management, and revenue cycle optimization. Contact us today to experience the benefits of outsourcing OB/GYN billing services.
FAQS
Frequently Asked Questions.
What services are included in OB/GYN billing?
MZ Medical Billing handles the entire revenue cycle, including CPT and ICD-10 coding, claim submission, denial management, prior authorizations, telehealth billing, payment posting, AR recovery, and provider credentialing.
