The New Obstetric Codes: Preparing Your Practice for the 2027 Maternity Care Transition-Handout: New OB Codes (2027)

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The document is an ACOOG presentation on major obstetric billing changes taking effect January 1, 2027. It explains why existing global obstetric codes were revised: current billing did not adequately account for labor management, complex pregnancies, transfers of care, postpartum hemorrhage, laceration repair, or hysterectomy after cesarean delivery. The new system separates prenatal care, labor management, delivery, procedures, and postpartum care into more clinically specific services.<br /><br />A major theme is documentation. For prenatal and postpartum E/M visits, coders should use standard office visit rules based on medical decision making or time. Pregnancy is treated as a moderate problem for E/M coding purposes, but that does not mean every visit is moderate. Documentation should support the problem addressed, data reviewed, and risk of management decisions. Telehealth and remote patient monitoring are allowed when services meet guideline requirements.<br /><br />Labor management is now billed separately from delivery and is divided into straightforward vs. complex care, with one code billed per calendar day. Documentation should include admission details, maternal and fetal status, cervical exam, membrane status, interventions, and whether the labor became complex. Delivery coding depends on whether birth is vaginal or cesarean and whether there was a prior cesarean. New procedure codes include repair of third- and fourth-degree lacerations and subtotal/total hysterectomy after cesarean. Postpartum hemorrhage management emphasizes escalation from uterotonics to tamponade or surgery when needed.<br /><br />The presentation also urges clinicians to comment on CMS’s proposed adoption of competing G-codes that would mirror the old bundled system, asking stakeholders to support the new codes and oppose reverting to bundled maternity billing.

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Keywords

obstetric billing

ACOOG presentation

January 1 2027

global obstetric codes

labor management

prenatal care

postpartum care

documentation requirements

cesarean delivery

postpartum hemorrhage