OB/GYN ICD-10 Codes & CPT Codes

OB/GYN coding requires precision across prenatal, delivery, postpartum, and gynecological encounters. Global obstetric packages, trimester-specific codes, and procedure-level CPT detail are all critical to accurate billing. This page reflects the FY2026 ICD-10-CM code set and CPT 2026, plus newly finalized FY2027 ICD-10-CM codes (effective October 1, 2026) covering ectopic pregnancy specificity. This page covers the top ICD-10-CM and CPT codes used by OB/GYN practices across the United States.

FY 2027 ICD-10-CM (CMS, eff. 10/1/2026) · CPT 2026 (AMA) · All codes verified billable · Last verified: October 2026

🔍 Search Codes on This Page


Top ICD-10 Codes for OB/GYN

ICD-10 Code Description Billable
Z34.00 Encounter for supervision of normal first pregnancy, unspecified trimester ✓
N91.2 Amenorrhea, unspecified ✓
N94.3 Premenstrual tension syndrome ✓
N92.0 Excessive and frequent menstruation with regular cycle ✓
Z30.09 Encounter for other general counseling and advice on contraception ✓
N83.20 Unspecified ovarian cysts, unspecified side ✓
N89.0 Mild vaginal dysplasia (vaginal CIN I) ✓
Z12.72 Encounter for screening for malignant neoplasm of vagina ✓
O20.0 Threatened abortion ✓
N76.0 Acute vaginitis ✓
Z39.2 Encounter for routine postpartum follow-up ✓
N81.10 Cystocele, unspecified ✓
C53.9 Malignant neoplasm of cervix uteri, unspecified ✓
N95.1 Menopausal and female climacteric states ✓
O09.519 Supervision of elderly primigravida, unspecified trimester ✓
O30.001 Twin pregnancy, unspecified, unspecified trimester ✓
O34.21 Maternal care for uterine scar from previous cesarean delivery ✓
O21.0 Mild hyperemesis gravidarum ✓
N97.0 Female infertility associated with anovulation ✓
O60.00 Preterm labor without delivery, unspecified trimester ✓
N85.00 Endometrial hyperplasia, unspecified ✓
O14.00 Mild to moderate pre-eclampsia, unspecified trimester ✓
N80.0 Endometriosis of uterus ✓
Z34.30 Encounter for supervision of normal third trimester pregnancy, unspecified ✓
O09.529 Supervision of elderly multigravida, unspecified trimester ✓
N94.6 Dysmenorrhea, unspecified ✓
O36.5130 Maternal care for known or suspected placental insufficiency, third trimester, not applicable or unspecified ✓
N87.1 Moderate cervical dysplasia ✓
O42.00 Premature rupture of membranes, onset of labor within 24 hours, unspecified weeks of gestation ✓
Z01.411 Encounter for gynecological examination (general) (routine) with abnormal findings ✓
N94.89 Other specified conditions associated with female genital organs and menstrual cycle ✓
O26.00 Excess weight gain in pregnancy, unspecified trimester ✓
N83.00 Follicular cyst of ovary, unspecified side ✓
O47.00 False labor before 37 completed weeks of gestation, unspecified trimester ✓
N92.4 Excessive bleeding in the premenopausal period ✓
O23.10 Infections of bladder in pregnancy, unspecified trimester ✓
N81.2 Incomplete uterovaginal prolapse ✓
Z3A.36 36 weeks gestation of pregnancy ✓
O32.1XX0 Maternal care for breech presentation, not applicable or unspecified ✓
N94.0 Mittelschmerz ✓
O00.129 Unspecified interstitial ectopic pregnancy without intrauterine pregnancy — new FY2027 code, effective 10/1/2026 ✓
O00.31 Cesarean scar ectopic pregnancy without intrauterine pregnancy — new FY2027 code, effective 10/1/2026 ✓
O00.32 Cesarean scar ectopic pregnancy with intrauterine pregnancy (heterotopic) — new FY2027 code, effective 10/1/2026 ✓
O00.41 Cervical ectopic pregnancy without intrauterine pregnancy (new FY2027 code) ✓
O00.42 Cervical ectopic pregnancy with intrauterine pregnancy (new FY2027 code) ✓

Source: CMS ICD-10-CM Official Code Set FY 2026 · includes select FY 2027 additions effective October 1, 2026

Is Your OB/GYN Practice Losing Revenue to Coding Errors?

OmniMD’s OB/GYN EHR suggests the right ICD-10 and CPT codes at the point of care, reducing claim denials from day one.

Schedule a Free Demo  View OmniMD OB/GYN EHR ›

Common CPT Codes for OB/GYN Billing

CPT Code Description Medicare Rate* Common Modifiers
59400 Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care ~$2,340 -54, -55, -62
59510 Routine obstetric care including antepartum care, cesarean delivery, and postpartum care ~$2,690 -54, -55, -62
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester ~$107 -26, -TC
58100 Endometrial sampling (biopsy) with or without endocervical sampling, without cervical dilation ~$118 -25, -59
57455 Colposcopy of the cervix including upper/adjacent vagina with biopsy(s) of the cervix ~$194 -25, -59
99213 Office or other outpatient visit, established patient, low medical decision making complexity ~$92 -25, -95, -GT
99214 Office or other outpatient visit, established patient, moderate medical decision making complexity ~$130 -25, -95, -GT
57170 Diaphragm or cervical cap fitting with instructions ~$74 -25
58300 Insertion of intrauterine device (IUD) ~$105 -25, -59
58301 Removal of intrauterine device (IUD) ~$94 -25, -59
58661 Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy) N/A (facility only) -50, -51, -62, -80
58120 Dilation and curettage, diagnostic and/or therapeutic (nonobstetric) N/A (facility only) -58, -78, -79
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal ~$78 -26, -TC
57500 Biopsy of cervix, single or multiple, or local excision of lesion, with or without fulguration ~$138 -25, -59
59025 Fetal non-stress test ~$68 -26, -TC
81025 Urine pregnancy test, by visual color comparison methods ~$6 -QW
88141 Cytopathology, cervical or vaginal; requiring interpretation by physician ~$27 -26

*Approximate 2025 CMS national non-facility rate. Rates vary by geography, setting, and payer contract. Refer to the CMS Physician Fee Schedule for official rates.

Top Denial Reasons for OB/GYN Claims

⚠

Missing or Incorrect Diagnosis-Procedure Linkage

Payers deny OB/GYN claims when the ICD-10 diagnosis code does not clinically support the billed CPT procedure (e.g., billing a colposcopy with only a well-woman visit diagnosis). Always link procedure codes to a specific, supporting diagnosis and document medical necessity explicitly in the encounter note.

⚠

Global Obstetric Package Unbundling

Billing individual antepartum visits (99213/99214) during a global OB episode (59400/59510) without proper modifier -52 or -54/-55 split-care documentation results in automatic denials. Ensure the global package is correctly assigned or use appropriate modifiers when care is divided between providers.

⚠

Prior Authorization Not Obtained for Procedures

Many payers require prior authorization for laparoscopic surgeries, hysteroscopy, and advanced imaging (e.g., 76805, 58661) especially under managed care plans. Verify authorization requirements before scheduling elective gynecologic procedures and attach the auth number in Box 23 of the claim form.

⚠

Modifier -25 Missing on Same-Day E/M and Procedure

When a significant, separately identifiable E/M service (99213/99214) is performed on the same day as a minor procedure (IUD insertion, endometrial biopsy, colposcopy), modifier -25 must be appended to the E/M code. Without it, payers bundle the office visit into the procedure fee and deny the E/M as included.

OB/GYN Billing & Coding Tips

  • Obstetric codes from Chapter 15 (O00–O9A) require a 7th character for the trimester (1, 2, 3) or delivery (4).
  • Global obstetric package CPT codes (59400, 59510) include all antepartum, delivery, and postpartum services — do not separately bill individual visits included in the global.
  • Code fetal conditions using Z3A.xx codes (weeks of gestation) as an additional code to all Chapter 15 codes.
  • Pap smear/cervical cytology (Q0091 or 88141–88175) is a preventive service and may have different patient cost-sharing rules than diagnostic services.

Frequently Asked Questions

What is the ICD-10 code for a normal prenatal visit?

Z34.00 is used for supervision of a normal first pregnancy in an unspecified trimester. Add Z3A.xx (weeks of gestation) as an additional code. For subsequent pregnancies, use Z34.30–Z34.39.

What does the global OB package include?

CPT 59400 (vaginal) and 59510 (cesarean) global packages include all antepartum visits from 4 weeks to delivery, the delivery, and the postpartum visit. Individual E&M visits during this period should not be billed separately to the same payer unless complications arise.

What ICD-10 code is used for menopause?

N95.1 covers menopausal and female climacteric states, including hot flashes, insomnia, and mood changes related to menopause. Z78.0 (Asymptomatic menopausal state) is used when there are no symptoms.

When is 57455 (colposcopy with biopsy) billed?

57455 is billed when the physician performs a colposcopy and takes a cervical biopsy during the same session. If no biopsy is taken, use 57420 (colposcopy without biopsy). Separate codes exist for ECC (57456) and LEEP (57461).

How does OmniMD support OB/GYN practices?

OmniMD’s OB/GYN EHR provides trimester-aware documentation templates, global OB package tracking, and integrated e-prescribing for prenatal vitamins and obstetric medications with cross-check for contraindicated drugs.

Streamline Your OB/GYN Practice with OmniMD

Purpose-built EHR, billing, and practice management for OB/GYN practices.

Book a Free Demo