DIET & NUTRITION 
PATIENT EDUCATION 
OBESITY/WEIGHT MANAGEMENT 
EXERCISE/TRAINING 
LEGAL MATTERS 
GUIDELINES/RECOMMENDATIONS After 30 years of global obstetric billing, the AMA’s CPT Editorial Panel approved a structural overhaul of maternity codes effective January 1, 2027. The change deletes 17 codes (including 59400, 59510, 59610, 59618, 59430), revises 6, and adds 12 new codes that split maternity care into four reportable phases.
Professional Impact
- Antepartum care moves to per-encounter E/M reporting (99202-99215 office, 99221-99239 facility) with modifier TH appended
- Labor management introduces four new codes distinguishing initial versus subsequent day and straightforward versus complex, reported once per calendar date
- Delivery codes no longer differentiate by performing clinician or VBAC attempt; complexity is now captured through labor management codes instead
- Payer scrutiny is rising: Blue Health Intelligence flagged $22 million in maternity overbilling tied to AI-generated posthemorrhagic anemia claims, signaling coming audit pressure
Action Items
- Train clinical and coding staff on the four-phase structure before January 1, 2027
- Update documentation templates to support phase-specific E/M and labor complexity coding
- Review state Medicaid requirements, particularly Category II tracking codes where applicable
- Establish internal audit protocols for AI-generated codes, particularly hemorrhage-related diagnoses
- Document straightforward-to-complex labor escalations clearly to support complex code selection
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