Billing built for gynecology, not generic medical.
Gynecology is procedure-heavy billing with preventive care intertwined. Colposcopy plus biopsy plus pathology, IUD J-codes, and same-day well-woman visits with problem-focused encounters all trip up general billers. Add modifier 25 questions and hysterectomy global periods and revenue leaks fast. Our GYN coders catch what others miss. Same 4.99% flat rate.
Gynecology CPT codes we handle every day.
Surgical global periods, colposcopy plus biopsy combinations, and IUD J-code billing. Our GYN coders know the details general billers miss.
Total Abdominal Hysterectomy
With or without salpingo-oophorectomy. 90-day global period. Prior authorization required by most commercial payers.
Hysteroscopy with Biopsy
Hysteroscopy with sampling of endometrium and/or polypectomy. Common denial trap when billed with 58555.
IUD Insertion
Bill separately from device HCPCS J7300, J7301, J7307. Include LARC counseling documentation.
Endometrial Ablation
NovaSure or thermal balloon procedures. Prior authorization required. 10-day global period.
Colposcopy with Biopsy
Cervical biopsy plus endocervical curettage. Include Pap smear results and abnormal cytology documentation.
Cervical Biopsy
Punch biopsy of cervix. Cannot bill with 57455 or 57456 on same session per NCCI edits.
Vulvar Lesion Destruction
Simple destruction, one or few lesions. Modifier 25 required with E/M same-day encounter.
Perineal Repair
Partial hymenectomy or perineal repair. 10-day global period. Bill with appropriate ICD-10 justification.
Total Hysterectomy - Abdominal
Corpus and cervix removal via abdominal approach. Documentation must specify uterine weight and pathology.
Total Hysterectomy - Abdominal with Colpo-Urethrocystopexy
Includes bladder suspension. Bill with 51840 or 57282 for pelvic floor repair combinations.
Supracervical Abdominal Hysterectomy
Corpus only, cervix preserved. Requires clear documentation of surgical approach.
Vaginal Hysterectomy
Uterus 250g or less. Different code (58262-58270) for larger uteri or additional procedures.
Hysterectomy - Vaginal with Colpectomy
Complete vaginal removal with colpectomy. Modifier documentation critical.
Total Laparoscopic Hysterectomy
Uterus 250g or less. Bilateral salpingo-oophorectomy separately billable with 58571.
Laparoscopic Salpingo-Oophorectomy
Removal of one or both fallopian tubes and ovaries via laparoscopy. Include laterality modifier.
Salpingo-Oophorectomy - Open
Unilateral or bilateral via open approach. Documentation must specify indication (adnexal mass, torsion).
Sling Operation for Stress Incontinence
Suburethral or bladder neck sling procedure. Prior authorization always required by most payers.
Unlisted Female Genital Procedure
Requires special report with operative details and comparative CPT code justification. Often denied - include peer-reviewed literature.
Transvaginal Ultrasound
Non-obstetric ultrasound. Bill professional (26) and technical (TC) components based on POS.
Saline Infusion Sonohysterography
SIS procedure. Bundled with 76830 same session unless clearly separate diagnosis.
Pelvic Ultrasound - Complete
Real-time with image documentation. Include all organs and required imaging views documentation.
Pelvic Ultrasound - Limited
Follow-up or limited exam. Cannot bill with 76856 same session per NCCI edits.
Cytopathology Interpretation
Pap smear interpretation. Reflex HPV testing separately billable with 87624 or 87625.
Cytopathology - Automated
Thin prep automated screening. Bundle rules vary by payer for reflex testing.
HPV DNA Testing - High Risk
Reflex or standalone HPV testing. Prior authorization for some payers when standalone.
Screening Pap Smear Collection
Medicare-specific code for Pap collection. Cannot bill with E/M unless Modifier 25 justified.
Cervical or Vaginal Cancer Screening
Medicare pelvic and breast exam. Every 24 months for low-risk, annual for high-risk.
Preventive Visit - Ages 18-39
Comprehensive preventive medicine, new patient. Bill with age-appropriate screening codes.
Preventive Visit - Ages 18-39 Established
Established patient preventive. Cannot bill same-day E/M unless significant separate service.
Established Patient Office Visit - Level 3
Low complexity established patient E/M. Time-based billing option since 2021 changes.
Where gynecology billing usually breaks.
Three patterns account for most denials in gynecology. Our specialized coders catch these before submission.
Preventive vs Diagnostic
Well-woman visits denied when a problem is addressed same day. Payer sees one code, not two.
Missing Modifier 25
Same-day E/M with procedure denied for missing modifier 25 on the E/M line. Common with IUD insertions and biopsies.
IUD J-Code Errors
Device J-code (J7297, J7300, J7301, J7302) missing from claim. Payer pays procedure but not the device, huge revenue loss.
Each gynecology sub-specialty billed differently. We handle all of them.
Coders matched to your sub-specialty. Office gynecology billing looks nothing like gyn-oncology or urogynecology, and infertility has its own complex rules.
Office Gynecology
Well-woman visits, contraceptive counseling, IUD management, pap smears. Highest volume in most practices. Preventive rules critical.
Gynecological Surgery
Hysterectomy, myomectomy, oophorectomy, salpingectomy. Complex global periods, modifier 51 and 59 rules apply.
Cervical & Uterine Procedures
Colposcopy, hysteroscopy, endometrial biopsy, ablation. Combination billing requires strict NCCI edit awareness.
Urogynecology
Pelvic floor procedures, incontinence surgery, prolapse repair. Overlap with urology billing rules on some codes.
Gyn Oncology
Cancer surgeries, chemotherapy administration, tumor markers. Global periods for radical procedures often 90 days.
Infertility & REI
Hormone panels, ultrasound monitoring, hysterosalpingogram. Coverage varies dramatically by payer and state mandates.
Gynecology-specific rules we track for you.
Preventive coverage under the ACA, IUD J-code updates, and state-mandated infertility coverage all evolve. We track updates so your practice doesn’t leak revenue on rule changes.
Well-woman and contraceptive coverage rules current
ACA requires zero-cost preventive care for well-woman visits, contraception, and specific screenings (pap, HPV, BRCA counseling). Miscoded and it bills as diagnostic, patient gets a bill, complaints follow. We keep the split clean.
Contraceptive device HCPCS pricing tracked quarterly
IUD device pricing (J7297 Liletta, J7300 Paragard, J7301 Skyla, J7302 Mirena, J7307 Nexplanon) updates quarterly. Miss the update and you underbill for weeks. We stay current on every device your practice uses.
USPSTF and ACOG guideline changes applied to billing
Cervical cancer screening guidelines updated in 2020: co-testing every 5 years replaces annual pap for many age groups. Payer coverage frequency limits followed the guidelines. We track patient screening intervals and prevent frequency denials.
State-mandated infertility coverage tracked
17+ states mandate some level of infertility coverage. Rules vary from basic diagnostic coverage to full IVF coverage. Employer self-funded plans can opt out under ERISA. We know which patient is covered under which rules for your state.
Full-service gynecology billing.
Everything a GYN practice needs, from routine well-woman visits to major surgery and complex sub-specialty billing.
Well-Woman & Preventive
ACA-covered preventive services billed correctly with no unexpected patient charges.
Gynecological Surgery
Hysterectomy, myomectomy, ablation with proper global period tracking.
IUD & Contraception
Device J-codes matched to inventory. Modifier 25 applied on same-day visits.
Colposcopy & Biopsy
Combination billing with proper NCCI awareness. Pathology J-codes included.
Sub-specialty Billing
Urogynecology, gyn-oncology, infertility handled by matched coders.
Dedicated Manager
Same person answers when you have modifier 25 questions or need an appeal filed.
“We’re a four-provider GYN group and our old biller kept forgetting to add the J-code when we inserted IUDs. We were losing eight hundred dollars per IUD we placed. CureMed fixed it in the first week and back-billed everything they could recover. Forty-seven thousand a month, gone before they showed up.”
Common questions about gynecology billing.
What is gynecology billing?
Gynecology billing covers claims for female reproductive health services outside of obstetric care, including gynecological surgeries, colposcopy and biopsy procedures, endometrial ablations, IUD insertion and removal, contraceptive counseling, well-woman visits, and hormone management.
What are the most common gynecology CPT codes?
Common gynecology CPT codes include 58150 (total hysterectomy), 57454 (colposcopy with biopsy), 58558 (hysteroscopy with biopsy), 58300 (IUD insertion), 58301 (IUD removal), 99385/99395 (well-woman preventive visits), and 57170 (diaphragm fitting).
Why do gynecology claims get denied?
Top reasons include preventive versus diagnostic coding errors (32%), missing modifier 25 on same-day E/M plus procedure (24%), and IUD/contraception device J-code documentation gaps (18%).
Do you bill IUD J-codes correctly?
Yes. IUD device billing is a common revenue leak. We match the procedure code (58300 or 58301) to the correct device J-code (J7297 Liletta, J7300 Paragard, J7301 Skyla, J7302 Mirena, J7307 Nexplanon) so both the procedure and device get reimbursed.
How do you handle infertility billing coverage?
Infertility coverage varies dramatically by state and payer. Some states mandate basic diagnostic coverage, some mandate full IVF coverage, and self-funded ERISA plans can opt out entirely. We verify each patient’s coverage at scheduling so you know what’s billable before services are rendered.
Ready for billing that actually speaks gynecology?
Send us three months of your GYN claims and denials. We’ll deliver a free gynecology-specific audit within a week showing exactly where your revenue is slipping, especially on IUD J-codes and modifier 25.