OB/GYN practices lose $72,000–$110,000 a year on average to global package misbilling, missed antepartum unbundling, and preventable delivery code denials — almost all of it at the coding stage, not the payer's.
Common Billing Challenges
These are the six billing failure points we see most often in OB/GYN practices — and the ones our team resolves systematically from day one.
Billing the global OB code (59400/59510) when a patient transferred mid-pregnancy or a covering physician delivered underpays the practice and creates real audit exposure — the component codes reimburse 20-30% more in those scenarios.
When care is split between providers, the antepartum-only (59425/59426) and delivery-only (59410/59515) codes must be selected correctly based on exactly how many visits and which portion of care each physician provided.
Obstetric ultrasounds (76801, 76805, 76811) are never part of the global package, but payers routinely bundle them incorrectly — one of the most common and most recoverable OB denial patterns.
Increased procedural services on a complex delivery require a cover letter explaining the added complexity with every claim. Missing documentation is the single biggest reason Modifier 22 claims get denied outright.
Group practices where a different on-call physician delivers than the one who provided antepartum care need airtight documentation to bill the correct split codes instead of defaulting to the (wrong) global package.
Colposcopy, IUD insertion/removal, hysteroscopy, and LEEP each carry their own global periods and bundling rules — billed incorrectly, they trigger denials for a same-day office visit or a missing device J-code.
Key Procedure Codes
Our coders hold specialty-specific credentials and train continuously on the codes that drive the most revenue — and the most denials — in OB/GYN.
| CPT Code | Description | Common Issue |
|---|---|---|
| 59400 | Vaginal delivery, global package | Billed when care was split — should be component codes |
| 59510 | Cesarean delivery, global package | Delivery code must match operative report exactly |
| 59425/59426 | Antepartum care only (4–6 / 7+ visits) | Used when patient transfers mid-pregnancy |
| 76805 | OB ultrasound, 2nd/3rd trimester | Incorrectly bundled into global package by payer |
| 58300 | IUD insertion | Device (J-code) must be billed separately |
| 57454 | Colposcopy with biopsy and ECC | Don't unbundle into 57455 + 57456 separately |
Why Rcmaxis
We're not a generalist billing service that added a specialty module. Our team is built around specialty-specific expertise.
Every coder on your account holds the specialty coding credential relevant to OB/GYN — not a generic CPC only.
Significantly above the 12.9% industry denial rate for this specialty. Fewer rejections means faster payment and less write-off risk.
Full EHR integration, payer enrollment verification, and charge capture setup in 2 weeks — with zero disruption to your clinical schedule.
One point of contact who knows your practice, your payers, and your billing history — available for weekly calls and monthly performance reviews.
Month-to-month engagement. We earn your business every month by improving your collections — not by locking you in.
Live visibility into your collections, denial rate, aging AR, and payer performance — updated daily, reviewed monthly with your account team.
Straight answers to what practices usually ask before they switch.
Free revenue assessment for qualified practices. We audit your last 90 days of claims, identify every revenue leak, and show you a clear path to better collections — at no cost.