For years, routine prenatal care, delivery, and postpartum visits were billed as one package at the end of a pregnancy. CPT deletes those global codes on January 1, 2027, and ACOG recommends billing antepartum visits with E/M codes now. Gynecology visits, preventive care, and procedures keep their own rules alongside the change.
Book a demoObstetric care is billed across a pregnancy. Gynecology is billed visit by visit. Mixing the two causes most of the rework.
Through 2026, codes such as 59400 bundle routine antepartum visits, delivery, and postpartum care into one claim, with separate codes for antepartum-only or delivery-only care when patients transfer. Deliveries in 2027 move to new labor management and delivery codes, so pregnancies that span the change need a plan.
Well-woman visits, contraceptive care, and cervical cancer screening are preventive services most plans cover without cost sharing. Problem visits, colposcopy, and office procedures are billed on their own, and a preventive visit that also treats a new problem needs documentation for both.
Visits for pregnancy complications, ultrasounds, and similar services have long been billed outside the routine package. ACOG notes that services at or near delivery, such as long-acting reversible contraception, should be billed separately.
A pregnancy can start under one billing method and end under another. Decide who owns each stage.
Clinicians document each prenatal visit, delivery, and postpartum check and approve drafted codes. Your staff keeps track of where each pregnancy stands and any transfer of care.
Gynecology claims and obstetric visits as they happen: eligibility checks, scrubbing, submission, and every denial and appeal. Patient statements and follow-up come with it.
Pregnancies already in progress under a global package, hospital delivery claims, and payers still on older policies need a clear owner. Agree on who bills which pregnancies during the transition.
Bring de-identified examples and each payer's current maternity billing policy. Keep patient details out of the booking form.
Note which plans already accept E/M codes with the TH modifier and which still expect a global claim.
List hospitals and birth centers, who documents labor and delivery, and how those records reach billing.
Estimate preventive, problem, and procedural gynecology volume, including office procedures like colposcopy and IUD insertion.
Useful to an independent OB-GYN practice that wants help moving from end-of-pregnancy global claims to visit-level billing, while keeping gynecology claims and appeals current.
ACOG has published recommendations, but each payer sets its own transition timing and rules. This page does not decide how any pregnancy or visit should be coded.
ACOG recommends billing antepartum visits with E/M codes and the TH modifier now, because the global codes are deleted on January 1, 2027. Check each payer's transition policy first.
CPT already directs E/M codes in that case. For four to six visits or seven or more, 59425 and 59426 remain available through 2026.
Plans that follow the ACA preventive services rules cover prenatal visits and screenings without cost sharing. Grandfathered or exempt plans may differ, so verify eligibility before the first visit.
Taiga can run in parallel with your current process or take over open A/R, so splitting the transition by service line is a fair topic for the fit call.
Share your payer list, a count of active pregnancies by expected delivery month, and recent denials. Taiga will tell you what it could own through the transition.
System guides show possible billing handoffs, not proven specialty compatibility.