How Obstetrics Billing Services Tackle Complex CPT Codes?

In the complicated maze of RCM in the US, understanding CPT codes is highly important. Always remember that these codes are the backbone of the billing and reimbursement process. Hence, proper coding makes sure the healthcare providers are accurately compensated so that no claim denial occurs. However, as the healthcare providers perform almost all the healthcare operations, they can’t give time to patient care. So, what can you do to tackle this situation? You can take the help of obstetrics billing services, which can take care of this process. So, let’s dive into the common codes, which are highly beneficial for OBGYN claims.  

Common OBGYN CPT Codes  

The CPT codes for obstetrics and gynecology include a wide range of services. These services start from routine prenatal care to complex surgical procedures. Hence, familiarity with these codes is highly important for accurate billing and proper reimbursement. Now, let’s dive into the OBGYN CPT Codes for routine obstetric care.  

CPT Code 59400 – Prenatal Care, Normal Delivery & Postpartum Care  

These OB-GYN CPT codes cover antepartum care, which includes routine prenatal visits. Moreover, it also includes vaginal delivery, which is the delivery of the fetus and placenta via the vaginal canal. Finally, it also helps with postpartum care, which includes follow-up visits to monitor the mother’s recovery. You need to note that CPT 59400 is a global code, as it includes services related to delivery, pregnancy, and postpartum care.  

CPT Code 59510 – Prenatal Care, Cesarean Delivery & Postpartum Care  

The CPT 59510 incorporates pregnancies culminating in cesarean section. This CPT code encompasses antepartum care, which includes prenatal visits. It also incorporates cesarean delivery, which is the surgical delivery of the fetus and postpartum care. This code is a global service, which covers the related care from prenatal to postpartum. However, if you don’t want to deal with all these codes, you may consider hiring obstetrics billing services for this matter.  

CPT Code 59610 – Prenatal Care, Normal Delivery after Previous Cesarean Birth, Postpartum Care  

The 59610 CPT code is applied when a patient with a cesarean delivery history opts for vaginal birth. This code includes antepartum care, including prenatal visits. It also incorporates vaginal delivery, which is the delivery via the vaginal canal after a previous cesarean, and also postpartum care, which includes follow-up visits. This code acknowledges the complexity of managing vaginal delivery after a cesarean.  

CPT Code 59618 – Prenatal Care, Cesarean Delivery after Attempted Normal Birth, Postpartum Care  

The CPT 59618 is used in scenarios where a patient attempts a vaginal delivery but needs a cesarean section. This code is also used for antepartum care for prenatal visits, cesarean delivery, which is the surgical delivery after a failed vaginal attempt, and finally, postpartum care is the follow-up visits. Hence, this code reflects the nuanced care involved in several cases.  

Apart from these codes, there are several other GYN CPT codes, such as 57452, 58100, 76801-76828, and 76830, which one needs to have knowledge of. So, if your healthcare staff doesn’t have the time for all these, it’s better to hire obstetrics billing services in that matter.  

Related Reading: 8 Frequent Obstetric Billing Errors and Proven Ways to Correct Them

OBGYN CPT Codes for Surgical Procedures  

There are several codes used for surgical procedures, which include CPT code 58140 for Myomectomy. It is applicable for the surgical removal of uterine fibroids. Apart from that, the CPT code 58150 is used for Hysterectomy, which includes the removal of the uterus. In addition to all these, CPT code 58570 is used for a laparoscopic procedure, and 58700 is used for a fallopian tube excision. Finally, CPT code 58956 is used for the ovary excision procedure.  

OBGYN CPT Codes for Infertility Treatment  

It also consists of several CPT codes, such as 58970, which is for in-vitro fertilization, which covers the collection of eggs from the ovarian follicles. Moreover, the 58974 code is used for in vitro fertilization, which is embryo transfer. This is used for placing fertilized embryos in the uterus. Finally, CPT code 58976 is used for Gamete Intrafallopian Transfer, which is used to place eggs and sperm directly into the fallopian tubes.   

OBGYN CPT Codes for Contraceptive Devices/Procedures  

The CPT code 58300 is used for the insertion of an intrauterine device. It is basically used while placing an intrauterine device for contraception, as IUDs are a reversible, long-term contraceptive option. Apart from that, CPT code 58301 is also used for the removal of an intrauterine device, where IUD removal is needed. However, this procedure can be performed when a device is no longer needed. Here, you can take the help of obstetrics billing services that know all these processes.  

OBGYN CPT Codes for Reproductive Health Procedures  

The CPT codes, such as 59812, are used for the surgical removal of unexpelled miscarriage contents and are used to remove tissues from the uterus after someone has a miscarriage. Moreover, the CPT code 59840 is used for induced abortion, which is performed under specific medical guidance.  

OBGYN Coding Guidelines  

You need to follow proper coding guidelines in an OBGYN practice to make sure no claim denial occurs. The guidelines are as follows:  

Frequently Update Coding Knowledge  

The coding regulations are constantly changing to protect patient data. However, as the healthcare staff deals with patient care, it can be a feasible option to outsource obstetrics billing services that can take care of these issues. Apart from that, their coders also know the HIPAA law to protect patient data.  

Use Appropriate Diagnostic Codes (ICD-10)  

The prior authorization is a very complex and time-consuming process. So, if you don’t want your healthcare staff to deal with this, you can take the help of outsourced experts. They can help you to verify patient eligibility, collect important patient documents, and submit prior authorization requests so that no claim denial occurs.  

Using the Right Technology  

Technology plays an essential role in speeding up the claim submission process. The outsourced obstetrics billing services know all the latest technologies, along with the EHR, to store patient data. Apart from that, they also know how to submit an electronic prior authorization procedure to submit claims electronically.   

Do you know which healthcare providers suffer the most? There are several challenges associated with inaccurate codes such as claim denials and payment delays. So, should you bring outsourcing or in-house experts? Moreover, as there are so many RCM companies out there, how can you choose the right expert for your clinic? That’s where SunKnowledge comes in as your trusted ally.  

Related Reading: Secure Your Gynecology Billing Revenue with SunKnowledge’s Shrewd Solutions

SunKnowledge: Your Complete RCM Expert  

We have years of experience in OBGYN billing, and we also provide a comprehensive OBGYN billing solution. Apart from that, our experts also help with timely and precise claim submission, AR and denial management, and finally, compliance and regulatory adherence. We can help increase your revenue by reducing denied claims. SunKnowledge provides cost-effective solutions and can seamlessly integrate with your EHR system. Our experts are totally HIPAA compliant and also know all the complex nuances of the CPT, ICD, and HCPCS codes to streamline claim submission. We can reduce your operational costs by 80% and our experts work with 99.9% accuracy. SunKnowledge also provides free dedicated account managers at no extra cost, and we don’t have any binding contracts with 30 30-day exit clause. We provide dedicated employees with US phone numbers, who work in real-time and are accessible during US working days. Our company also has a 10% buffer resource and less than 48 hours of turnaround time. We provide robust and customized reporting and top-of-the-line infrastructure setup. Apart from OBGYN, SunKnowledge also helps with cardiology, DME, infusion, urgent care, and many other specialties.  

So, take the step today and see the difference that you can make by partnering with a reputable obstetrics billing service like SunKnowledge.  

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