OB-GYN Coding Guidelines and Best practices

OB-GYN Coding Guidelines and Best practices

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What is Obstetrics & Gynecology?

Obstetrics & Gynecology is a branch of medicine specializing in women’s care during pregnancy and childbirth and in diagnosing and treating diseases of the female reproductive organs. It also specializes in other women’s health issues, such as menopause, hormone problems, contraception (birth control), and infertility.

 

Typical CPT Codes and the Guidelines for their application

CPT code Range

The CPT code for Obstetrics & Gynecology ranges from 56405 – 58999, including procedures done in the female genital system and maternity care & delivery.

Guidelines

  • Antepartum care includes:

    • Initial prenatal history and physical examination

    • Subsequent prenatal history and examination

    • Recording weight, blood pressures, fetal heart tones, routine chemical urinalysis

    • Monthly visits up to 28 weeks gestation

    • Biweekly visits to 36 weeks gestation; and weekly visits until delivery

  • The coder should code any other visits or services within this time separately

  • Coders should not consider pregnancy confirmation during problem-oriented or preventive visits as a part of antepartum care, and they should report using the appropriate E/M services (99202 – 99215, 99241 – 99245)

  • Delivery and postpartum services (59410, 59515, 59614, 59622) include delivery services and all inpatient & outpatient postpartum services.

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