
OB/GYN Medical Billing & Coding Alert
Global obstetric codes encompass antepartum care, delivery, and postpartum services. These codes apply when a single provider or practice delivers all of the patient’s routine obstetric care. If global billing is not appropriate due to specific circumstances, the global obstetric section also includes codes that permit individual billing for each component of the overall care package.
Antepartum Care Overview
Antepartum care involves the routine services provided during an uncomplicated pregnancy. Routine obstetric care typically includes approximately 13 antepartum visits, which include the following:
- Initial and follow-up medical history
- Physical examinations
- Monitoring of weight, blood pressure, and fetal heart tones
- Routine urine dipstick testing
- Monthly visits through 28 weeks (approximately 5–6 visits)
- Biweekly visits from 28 to 36 weeks (approximately 4 visits)
- Weekly visits from 36 weeks until delivery (approximately 3–4 visits)
Services Included in the Global Obstetric Code
The global obstetric code includes payment to the physician or qualified health care professional for a comprehensive set of delivery-related services. These typically cover:
- Hospital admission, including the admitting history and physical examination
- Management of uncomplicated labor
- Vaginal or cesarean delivery (with or without the use of episiotomy, forceps, or vacuum extraction)
- Delivery of the placenta
- Routine inpatient care immediately following delivery
- Induction of labor, unless the provider personally initiates and remains with the patient during the infusion
- Insertion of a cervical dilator on the day of delivery (CPT code 59200)
- Simple removal of cerclage when not performed under anesthesia
Postpartum Services and Exceptions to Global Obstetric Billing
Postpartum care is included in the global obstetric code, though CPT codes do not clearly define the length of the postpartum period. It is generally considered to be the first 6 weeks after delivery, though the American College of Obstetricians and Gynecologists (ACOG) notes that routine postpartum care may extend up to 12 weeks. Postpartum services typically include:
- Recovery room visit
- Uncomplicated inpatient hospital visits
- Uncomplicated outpatient visits
- Contraception counseling
- Suture removal, when applicable
When the Global Obstetric Package Cannot Be Reported
Providers may not report the complete global obstetric package in the following situations:
- More than one physician or qualified obstetric health professional (QOHP) or practice provides routine obstetric care.
- A single physician or practice provides significantly fewer services than are included in the standard package.
- The patient changes insurance providers during pregnancy.
- The patient transfers into or out of the practice during pregnancy.
- The pregnancy ends in miscarriage or termination.
Services Outside the Global Obstetric Package
Certain services fall outside the scope of the global obstetric package and may be reported separately at the time they are provided. These include:
- Medically necessary diagnostic tests and procedures.
- Facility-based evaluation and management (E/M) services.
- Services unrelated to pregnancy, such as treatment for an upper respiratory infection or urinary tract infection.
If pregnancy complications result in additional antepartum visits beyond the typical 13, those extra visits may be billed as E/M services at the time of delivery. These visits must be associated with appropriate diagnosis codes, such as gestational diabetes or placenta previa.
Note: Any facility-based E/M service provided on the calendar date of delivery or the day prior is considered part of the delivery and cannot be billed separately.
BillingFreedom. Delivers the Best in Global Obstetric Billing
BillingFreedom is your trusted partner for accurate and efficient global OB billing. We specialize in managing obstetric services, including antepartum care, delivery, and postpartum visits.
Our team ensures proper use of global codes and identifies when separate billing is needed due to provider changes, insurance transitions, complications, or additional visits. We also handle services outside the global package, such as diagnostic tests and unrelated medical concerns. With a deep understanding of billing guidelines and payer requirements, BillingFreedom helps reduce claim denials and accelerates reimbursements.
Our expertise allows healthcare providers to focus on patient care while we handle billing. Choose BillingFreedom for reliable support and proven results in obstetric billing.
For more details about our exceptional ob/gyn medical billing services, please don't hesitate to email us at info@billingfreedom.com or call us at +1 (855) 415-3472.
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