August 2019

Global Obstetric Services: Use Caution to Ensure Proper Coding on Claims

Obstetrical services are processed in accordance with Current Procedural Terminology (CPT^®) coding guidelines. Global obstetric services fall into the following categories:

• Antepartum care (care provided prior to delivery)
• Delivery
• Postpartum care (care provided after delivery)

According to CPT coding guidelines, if only one physician treated a patient for an entire pregnancy, to include all antepartum care visits, delivery and ending with postpartum care, billing with a global CPT code may be appropriate.

When an obstetrical patient requires the services of two (or more) different physicians during the course of pregnancy, however, it is the responsibility of each physician to bill for services using the appropriate CPT code that accurately describes the services they performed.

Here is an example from the 2019 CPT codebook published by the American Medical Association (AMA): “If all or part of the antepartum and/or postpartum patient care is provided except delivery due to termination of pregnancy by abortion or referral to another physician or other qualified health care professional for delivery, see the antepartum and postpartum codes….”

We appreciate the care and services you provide to our members. We also appreciate your attention to careful coding to ensure services performed are accurately reported on claims.

CPT copyright 2018 AMA. All rights reserved. CPT is a registered trademark of the AMA.

This material is provided for educational purposes only and is not intended to be a definitive source for coding claims. Health care providers are instructed to submit claims using the most appropriate code(s) based upon the medical record documentation and coding guidelines and reference materials.