Obstetrics & Gynecology is a subspecialty of medicine that focuses on the care of women during pregnancy and childbirth, as well as the diagnosis and treatment of illnesses of the female reproductive organs. Additionally, it focuses on other aspects of women’s health, such as menopause, hormonal imbalances, contraception (birth control), and infertility.
An OB/GYN practice performs a variety of operations, including surgeries, pre-and postnatal care, and routine health checks for women.
Expertise In OB/GYN Billing & Coding
At Swift Medical Billing, our client base spans all 50 states and includes a diverse spectrum of hospitals, physician offices (including OB/GYN clinics), and medical firms. Our team of billers and coders leverage their experience and knowledge gained from working with obstetricians and gynecologists for the purpose of increasing revenue and driving growth. Swift Medical coders are certified by the American Academy of Professional Coders in ICD-9/10, CPT, and HCPCS coding rules supplied by CMS and AMA (AAPC). Our billing and coding expertise in OB/GYN includes the following specialties:
- Obstetrics and Gynecology
- Endocrinology of the Reproductive System and Infertility
- Uro-gynecology and Pelvic Reconstructive Surgery Gynecological Uro-gynecology and Pelvic Reconstructive Surgery
- Laparoscopic Advanced Surgery
- Planning a Family
- Gynecology in Children and Adolescents
- Gynecology in Menopause and Geriatrics
Adhering To OB/GYN Coding And Billing Industry Standards
We understand the difficulties that OB/GYN clinicians encounter, including rapidly changing policy requirements, ICD revisions, and the sensitive nature of your specialty. Our certified coders are capable of selecting appropriate codes based on operative reports from actual surgical cases. We are available to you 24 hours a day to help you avoid problems caused by erroneous modifier usage and to teach your in-house billing professional how to avoid them.
Our specialized billing and coding staff works to minimize claim denials while improving payouts. This is accomplished through the use of effective. Streamlined methods that reduce the amount of time required to accurately bill for OB/GYN services.
Our strategy is based on strict adherence to coding standards and best practices, as well as the use of modern technologies. The MBW team is committed to providing data-driven solutions that aid in the reduction of denials and the growth of revenue.
Pros Of Using Our Services
OB GYN practitioners see a large number of patients, some infrequently, such as for yearly checkups, and others on a continuing basis for prenatal care and postpartum care. This requires medical coders and billers to be proactive in processing numerous claims and to understand all the components of bundled claims in order to avoid over or under coding, which not only results in charging too much or too little, but also constitutes a violation of the law and can be disastrous for a practice.
Coverage Is Extremely Diverse
Obstetrics and gynecology are two of the most frequently excluded or limited fields of medicine from insurance coverage. Many have elaborate regulations indicating which items are covered and which are not. This is something that should be clarified before the patient schedules. An appointment to avoid any unexpected costs being issued to them later.
A practitioner may visit the same patient in the clinic and in the hospital, necessitating meticulous coding for each. Billers must understand which procedures are billable in certain circumstances and ensure that everything is documented properly.
Claims At The Global Level
Certain payers and insurers combine care provided during pregnancy and childbirth into a single claim, which means the practitioner must provide nine months of service before being paid, and each claim is for a significant value, making it critical that claims are not rejected or refused.
How Do SWIFT Medical Billers Help You?
Our obstetrics and gynecology billers and coders would initiate a follow-up on patient claims that have been pending for more than 18 days and optimize your current cycle to 21 to 25 days, depending on the type of insurance accepted by your clinics, using their accumulated knowledge of the following:
- Coding accurately on the ICD 10 and CPT platforms
- Printing and distributing paper and electronic bills
- Pursuing unpaid and outstanding claims
- Pre-authorization for approaching operations is being worked on.
Important Highlights of OB/GYN Coding and Billing Services
- J2675 (Injection, progesterone) is a frequently used HCPCS code in OB/GYN, generating significant money for physicians.
- Reimbursement for HCPCS codes G0101, Q0091 is permitted just once per year, except in cases of medical necessity.
- To be reimbursed for CPT code 59514 (Cesarean delivery alone). An assistant surgeon must be present, as this is a highly compensated and complicated procedure.