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 FY 2027 ICD-10-CM code set (effective October 1, 2026), including new ectopic pregnancy codes, and CPT 2026. 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) · Codes checked against the FY 2027 ICD-10-CM tabular (CMS) · October 2026 · 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 ✓
Z30.430 Encounter for insertion of intrauterine contraceptive device ✓
Z30.432 Encounter for removal of intrauterine contraceptive device ✓
N83.209 Unspecified ovarian cyst, unspecified side ✓
N89.0 Mild vaginal dysplasia (VAIN I) ✓
Z12.72 Encounter for screening for malignant neoplasm of vagina ✓
Z12.4 Encounter for screening for malignant neoplasm of cervix ✓
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 ✓
O30.009 Twin pregnancy, unspecified number of placenta and unspecified number of amniotic sacs, unspecified trimester ✓
O34.211 Maternal care for low transverse scar from previous cesarean delivery ✓
O34.219 Maternal care for unspecified type 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 ✓
N80.00 Endometriosis of the uterus, unspecified ✓
N80.03 Adenomyosis of the uterus ✓
Z34.83 Encounter for supervision of other normal pregnancy, third trimester ✓
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 ✓
R87.612 Low grade squamous intraepithelial lesion on cytologic smear of cervix (LGSIL) ✓
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 ✓
Z01.419 Encounter for gynecological examination (general) (routine) without 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 2027 (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 ~$2,214 -22
59510 Routine obstetric care including antepartum care, cesarean delivery, and postpartum care ~$2,473 -22, -80, -82
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester ~$136 -26, -TC
58100 Endometrial sampling (biopsy) with or without endocervical sampling, without cervical dilation ~$98 -59
57455 Colposcopy of the cervix including upper/adjacent vagina with biopsy(s) of the cervix ~$161 -59
99213 Office or other outpatient visit, established patient, low medical decision making complexity ~$95 -25, -95
99214 Office or other outpatient visit, established patient, moderate medical decision making complexity ~$136 -25, -95
57170 Diaphragm or cervical cap fitting with instructions ~$73 None
58300 Insertion of intrauterine device (IUD) ~$106 -59
58301 Removal of intrauterine device (IUD) ~$112 -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) ~$298 -58, -78, -79
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal ~$93 -26, -TC
57500 Biopsy of cervix, single or multiple, or local excision of lesion, with or without fulguration ~$151 -59
59025 Fetal non-stress test ~$50 -26, -TC
81025 Urine pregnancy test, by visual color comparison methods ~$9 None (CLIA-waived; QW not required)
88141 Cytopathology, cervical or vaginal; requiring interpretation by physician ~$24 -26

*Approximate 2026 CMS national non-facility rate. Lab test rates are from the 2026 CMS Clinical Laboratory Fee Schedule. Rates vary by geography, setting, and payer contract. Refer to the CMS Physician Fee Schedule for official rates. Append -25 to the same-day E/M (99212–99215), not to the procedure.

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 routine antepartum visits (99213/99214) separately during a global OB episode (59400/59510) results in denials, because those visits are included in the global package. When care is divided between providers, do not use modifier -52 or -54/-55 on the global codes; report the component codes instead: 59425/59426 (antepartum care only), 59409/59410 or 59514/59515 (delivery only, or delivery plus postpartum care), and 59430 (postpartum care only).

⚠

Prior Authorization Not Obtained for Procedures

Many payers, especially managed care plans, require prior authorization for laparoscopic surgery (e.g., 58661), hysteroscopy, and some imaging such as pelvic MRI; some plans also limit the number of OB ultrasounds (76805/76817) per pregnancy. 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

  • In Chapter 15 (O00–O9A), the final character of most codes identifies the trimester (1 = first, 2 = second, 3 = third, 9 = unspecified); some categories also have “in childbirth” (4) or “in the puerperium” (5) options. Certain categories (e.g., O31, O32, O35, O36, O40, O41, O60.1–O60.2, O64, O69) also require a 7th character to identify the fetus (0 for a single gestation).
  • Global obstetric package CPT codes (59400, 59510) include routine antepartum, delivery, and postpartum services; do not separately bill individual visits included in the global.
  • On the maternal record, add a Z3A code (weeks of gestation) with Chapter 15 codes when the gestational age is known and applicable; Z3A codes are never reported on the newborn record.
  • 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 (non-first) pregnancies, use Z34.80–Z34.83 (Z34.81 first, Z34.82 second, Z34.83 third trimester).

What does the global OB package include?

CPT 59400 (vaginal) and 59510 (cesarean) include routine antepartum care (initial and subsequent history and physical exams, routine visits – typically monthly to 28 weeks, biweekly to 36 weeks, then weekly – and routine dipstick urinalysis), the delivery, and routine postpartum care in the hospital and office. The visit that confirms the pregnancy and visits for unrelated or complicating conditions may be billed separately.

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). If both a cervical biopsy and endocervical curettage are performed, report 57454 (not 57455 + 57456). ECC alone is 57456; colposcopy with loop electrode biopsy is 57460 and with loop electrode conization (LEEP cone) is 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