OB/GYN medical billing: where the global maternity package leaks revenue
In OB/GYN, one code stands in for almost a year of care. The global maternity package bundles the prenatal visits, the delivery, and the postpartum care into a single payment, and that makes it the most fragile line in the practice. Get one piece wrong and the whole delivery downcodes or denies.
The break points are quiet. The global only holds up when one practice documents the whole course of care. If the record cannot support the full set of prenatal visits, or the patient transferred in or out and the split was not itemized, the claim gets downcoded to a partial payment, a fraction of the delivery. Meanwhile the things that are supposed to be billed on their own, the ultrasounds, the non-stress tests, the first visit that confirms the pregnancy, get folded in and never collected. A practice can deliver the baby, do everything right clinically, and still lose several hundred dollars because the claim did not tell the story the payer wanted.
For an independent practice with no biller, that is a lot to track across every pregnancy and every payer's policies.
Altair is the done-for-you billing service, run by AI, backed by our expert in-house billers. We make the global hold up and catch the work that should be billed separately, on every payer's terms, before the claim goes out.
Talk to us, and we will show you what your maternity claims are leaving behind.
Common questions
Why did my whole delivery get downcoded?
The global maternity package only pays in full when the record supports the prenatal visit count and shows one practice provided the whole episode. If the count is not documented, or the patient transferred care without the split being itemized, the payer drops the global to a partial payment.
What am I allowed to bill outside the global?
Ultrasounds, non-stress tests, labs, and the initial visit that confirms the pregnancy are separate from the global and billable on their own with the right diagnosis. Folding them in forfeits real revenue.
Can Altair bill for us if we have no biller?
Yes. Altair is the done-for-you billing service for independent practices with no billing team, run by AI, backed by our expert in-house billers. We handle the global and the separately billable work, and work the denials.
Sources: CMS and commercial global obstetric package guidance; ACOG maternity coding guidance; CPT global maternity code definitions.