Demystifying Global Periods and CPT Codes in OBGYN Medical Billing Service

Managing OBGYN medical billing service has always been a struggle.  Especially in this competitive era – changes in rules and payer policies, coding guidelines and lots of other critical components further make the OBGYN billing process quite daunting.

Fortunately, you can still streamline a perfect OBGYN medical billing service by having a clear idea about the global period and frequently used codes in your billing system.

Efficient tips to implement a perfect OBGYN medical billing service:

As you know in maternity care, you’re the one managing antepartum care, delivery services, and postpartum care and it might confuse you at times. So, it is important to understand the difference between Obstetrics and gynecology (OBGYN) and the rest of the medical billing services:

Global period:

• You should know the global period is the time when the extra care you give is already included in the main payment for a service. For your ob-gyn care, the global period for pregnancy covers everything—before, during, and after delivery. However, the global period for surgeries depends on the type of surgery that you have performed. Always remember one thing – the global period always begins from the first visit after you confirm the pregnancy and it goes throughout the postpartum. It starts after 56-days of vaginal delivery and 90-days after c-section.
• You also should know that when you check a patient’s history and do a physical exam before a major surgery, it’s part of the global package. You shouldn’t bill for those separately.
• You can bill separately if you’re doing a surgical clearance for a patient with things like high blood pressure or heart problems. But most of the time, it’s another doctor, not you, who takes care of those clearances.
• You should know that most hospital procedures have a global period of either 10 or 90 days. During this time, you can’t bill separately for related check-ups or evaluations. You also need to use the right modifiers to show what services you provided.

Frequently used CPT codes in OBGYN medical billing services:

• You must use the 59400 code for regular pregnancy care in your OBGYN center. This code covers all your check-ups, vaginal delivery (with or without episiotomy or forceps), and postpartum care.
• You should always use the 59510 code for regular care, which includes your check-ups, a C-section delivery, and postpartum care.
• You should use the 59610 code when you’re handling care that includes your check-ups, vaginal delivery (with or without episiotomy or forceps), and postpartum care after a previous C-section.
• Always make sure you use the 59618 code for care that includes your check-ups, a C-section, and postpartum care after you’ve tried a vaginal delivery following a past C-section.
• You need to bill the global OB code when the same group of doctors or healthcare professionals handles all parts of pregnancy care. Don’t use separate billing codes for each check-up related to pregnancy—everything’s included in the package!

Unfortunately, the majority of mid and small-scaled OBGYB specialties do not have an efficient in-house team to manage the end-to-end revenue cycle management. Are you someone facing the same issue? No worries, you can make your billing stress disappear by partnering with a professional OBGYN billing company like Sun Knowledge Inc.

We don’t just specialize in OBGYN medical billing service—we’ve got your back across 30+ other specialties too!

What makes us unique? We’re the only RCM company that supports both payors and healthcare pros like you.

When you team up with us, you can hand over all the admin hassle and only focus on patient care while we, take care of your billing worries. The result? Better efficiency, improved care quality, and higher revenue—all at once! Curious to see how we can make it happen? Our experts are just a call away!