OB/GYN practices handle everything from preventive care and pregnancy management to surgeries and menopause counseling. To ensure full reimbursement and minimize denials, it’s critical to use the correct OB/GYN CPT codes and modifiers for 2025.
This guide covers essential Evaluation & Management (E/M), prenatal care, procedures, and diagnostic testing codes, plus common modifiers and ICD-10 pairings.
Evaluation & Management (E/M) Codes
CPT Code | Description |
99202–99205 | New patient office visits |
99212–99215 | Established patient office visits |
99221–99223 | Initial hospital care |
99231–99233 | Subsequent hospital care |
99238–99239 | Hospital discharge services |
Obstetric Services
CPT Code | Description |
59400 | Routine OB care (antepartum, delivery, postpartum) |
59409 | Vaginal delivery only |
59410 | Vaginal delivery with postpartum care |
59510 | Routine cesarean care |
59514 | Cesarean delivery only |
59515 | Cesarean with postpartum care |
59610 | VBAC vaginal delivery |
59618 | VBAC cesarean delivery |
Common Gynecological Procedures
CPT Code | Description |
57500 | Cervical biopsy |
58100 | Endometrial biopsy |
58300 | IUD insertion |
58301 | IUD removal |
58120 | Dilation and curettage (D&C) |
57454 | Colposcopy with biopsy and ECC |
58558 | Hysteroscopy with biopsy or polypectomy |
58661 | Laparoscopic removal of adnexal structures |
Diagnostic Tests and Screenings
CPT Code | Description |
81025 | Urine pregnancy test |
76801 | Obstetric ultrasound, first trimester |
76805 | Obstetric ultrasound, second/third trimester |
76856 | Pelvic ultrasound, non-obstetric |
87624 | HPV testing |
88175 | Automated Pap smear with rescreen |
OB/GYN Billing Modifiers
Modifier | Description |
-25 | Separate E/M on same day as procedure |
-59 | Distinct procedural service |
-76 | Repeat procedure by same provider |
-77 | Repeat procedure by another provider |
-24 | Unrelated E/M during global period |
-51 | Multiple procedures |
-TC | Technical component |
-26 | Professional component |
Common ICD-10 Codes for OB/GYN
ICD-10 Code | Description |
Z34.91 | Supervision of normal pregnancy, unspecified trimester |
N80.9 | Endometriosis, unspecified site |
N84.0 | Polyp of corpus uteri |
N92.5 | Other irregular menstruation |
Z12.4 | Screening for cervical cancer |
N93.9 | Abnormal uterine bleeding, unspecified |
Z30.09 | General contraception counseling |
OB/GYN Billing Tips for 2025
- Use global maternity care codes accurately based on care provided.
- Apply -25 when E/M is performed in addition to a procedure.
- Use -59 cautiously to separate bundled services.
- Ensure correct ICD-10 diagnosis coding for screenings vs. diagnostics.
Final Thoughts
OB/GYN billing can get complicated quickly, with bundled maternity care, preventive visits, and procedures often performed together. By staying current on OB/GYN CPT codes and modifiers for 2025, practices can avoid denials, reduce audits, and streamline reimbursement while focusing on excellent patient care.
For informational purposes only.