OB/GYN CPT Codes for 2023 + Modifiers

CPT codes, or Current Procedural Terminology codes, allow doctors and medical professionals to report medical services and procedures uniformly, easily, and accurately. Modifiers can be added to CPT codes to describe a procedure further or add extra details. Your OB/GYN practice can benefit from knowing the most updated CPT codes, as shown below for 2023.

Changes to Codes in 2023

The updated CPT codes for 2023, released by the American Medical Association (AMA) at the end of 2022, made a few changes to the current codes. These include establishing one set of evaluation and management services (E/M) guidelines, which should help make coding more streamlined throughout inpatient and outpatient practices. Additionally:

• Level one consultation codes 99241 and 99251 have been deleted
• The code 99281 may not require the presence of a physician or other qualified healthcare professional

Common OB/GYN CPT Codes 2023

The following are the newest CPT codes for common OB/GYN procedures and office visits.

Evaluation and Management

Consultations

The following are newly updated codes and ranges for consultation codes, according to the 2023 AMA guidelines.

• 99242: Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and straightforward medical decision-making
• 99243: Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and a low level of medical decision-making
• 99244: Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and a moderate level of medical decision-making
• 99245: Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and a high level of medical decision-making

Visits and Evaluations of Problems

• 99201: Problem-focused office visit from new patient
• 99202: Expanded problem-focused office visit from new patient
• 99203: Detailed office visit from new patient
• 99204: Comprehensive office visit from a new patient with a review of 2-9 symptoms
• 99205: Comprehensive office visit from a new patient with a review of 10 or more symptoms
• 99211: Straightforward office visit from established patient
• 99212: Problem-focused office visit from established patient
• 99213: Expanded problem-focused office visit from established patient
• 99214: Detailed office visit from established patient
• 99215: Comprehensive office visit from established patient

Common Birth CPT Codes

• 59400: Routine obstetric care for vaginal delivery (with or without episiotomy and/or forceps), including antepartum and postpartum care
• 59409: Vaginal delivery only
• 59410: Vaginal delivery only, including postpartum care
• 59425: Antepartum care only; 4-6 visits
• 59426: Antepartum care only; 7 or more visits
• 59510: Routine obstetric care for cesarean section delivery, including antepartum and postpartum care
• 59514: Cesarean delivery only
• 59515: Cesarean delivery only, including postpartum care
• 59610: Routine obstetric care for vaginal delivery (with or without episiotomy and/or forceps) after cesarean delivery, including antepartum and postpartum care
• 59612: Vaginal delivery only, after previous cesarean delivery
• 59614: Vaginal delivery only, after previous cesarean delivery; including postpartum care
• 59618: Routine obstetric care for cesarean delivery following attempted vaginal delivery after previous cesarean delivery, including antepartum and postpartum care
• 59620: Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery
• 59622: Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery; including postpartum care

Hysterectomy Code Ranges

• 58150-58210: Abdominal hysterectomy codes
• 58260-58291: Vaginal hysterectomy codes
• 58541-58573: Laparoscopic hysterectomy codes

Well Woman Visits

• 99385 well-patient visit for a new patient between the ages of 18-39
• 99386 well-patient visit for a new patient between the ages of 40-64
• 99387 well-patient visit for a new patient age 65 or older
• 99395 well-patient visit for an established patient between the ages of 18-39
• 99396 well-patient visit for an established patient between the ages of 40-64
• 99397 well-patient visit for an established patient age 65 or older
• 99000: office preparation of a specimen for lab analysis and or its transport from the office to the outside testing laboratory (such as a pap smear)

Contraception CPT Codes

• 58300: placement of intrauterine device (IUD)
• 58301: removal of IUD
• 11981: Insertion, non-biodegradable drug delivery implant
• 11982 Removal of non-biodegradable drug delivery implant
• 11983: Removal with reinsertion, non-biodegradable drug delivery implant

Common Ultrasound CPT Codes

• 76857: Ultrasound, pelvic [nonobstetric], real-time with image documentation; limited or follow-up (such as to view the placement of IUD)
• 76830: Ultrasound, transvaginal to assess reproductive organs
• 76831: Ultrasound examination with saline or color flow Dopper to enhance imaging
• 76801: Ultrasound of pregnant uterus during the first trimester of pregnancy using transabdominal approach
• 76805: Ultrasound of pregnant uterus after the first trimester of pregnancy using transabdominal approach
• 76811: Transabdominal ultrasound to examine pregnant fetus with additional examination of fetal anatomy such as the heart rate, amniotic fluid levels, etc.
• 76817: Ultrasound of pregnant uterus and mother using a transvaginal approach

Modifiers

Modifiers help modify CPT codes to add more detail or distinguish between repeat codes.

• 22: Additional or increased services, such as if a woman delivers twins
• 25: Separate evaluation on the same day as another procedure or service
• 91: Repeat tests taken on the same day with different specimens at different times
• 95: Synchronous telemedicine service rendered via real-time Interactive audio and video telecommunications system
• 310: Not vaccinated against COVID-19
• 311: Partly vaccinated against COVID-19
• 39: Indicates any other under-immunized status

Learn more in our OB/GYN medical billing services.

For informational purposes only.