OB/GYN
OB/GYN billing requires high level precision because the specialty spans preventive care, prenatal and postpartum management, gynecologic procedures, surgical interventions, and complex inpatient encounters. We ensure accurate ICD 10 CM diagnosis coding, CPT and HCPCS procedure coding, modifier usage, and compliant E/M service selection across inpatient, outpatient, and emergency department professional fee settings. Our team reviews documentation for pelvic exams, Pap smears, colposcopy, hysteroscopy, prenatal visits, labor and delivery services, and gynecologic surgeries to confirm medical necessity, anatomical specificity, and payer required elements are fully supported.
OB/GYN denials frequently arise from incorrect global obstetric billing, missing LMP/EDD documentation, incomplete procedure details, unclear linkage between pathology and gynecologic procedures, and insufficient justification for ultrasound frequency. We address these issues by strengthening documentation workflows, validating diagnosis to procedure alignment, and issuing provider queries when clarification is needed. Our audits focus on identifying missed billable components such as add on imaging codes, postpartum E/M services, contraceptive device insertions/removals, and separately reportable procedures performed during the same encounter. We reinforce HIPAA compliance, documentation integrity, and payer policy adherence while optimizing pro fee charge capture across IP/OP/ED settings. Through targeted education and specialty specific denial analysis, we help OB/GYN practices maintain a compliant, efficient revenue cycle that accurately reflects the full scope of obstetric and gynecologic care.