OB-GYN Coding Guidelines and Best practices
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.
