MedicaidBilling CodesHigh impact
Updated Billing Guidelines for Routine Labor and Delivery Claims
Maryland Medicaid·MD · OB-GYN, Pediatrics·Provider Transmittal
Effective date
May 11, 2020
We identified it
Jun 20, 2026
Summary
Maryland Medicaid updated billing requirements for routine labor and delivery claims effective May 11, 2020. Maternal delivery claims must no longer use Z37.x diagnosis codes in the primary position (per ICD-10 guidelines); instead, claims must include specific diagnosis, procedure, and revenue code combinations. Newborn claims continue to require Z38.x codes in primary position. Claims processed between February 1-May 8, 2020 will be reprocessed by the state without provider resubmission.
Action Required
By May 11, 2020: Billing team must immediately update Maryland Medicaid labor and delivery claim submission processes in billing software. (1) For maternal delivery claims: Remove Z37.x diagnosis codes from primary position on UB-04 forms; instead, ensure claims include the required combination of Z37.x diagnosis codes (non-primary), specific procedure codes (10D07Z3-10D07Z8 or 10E0XZZ for vaginal delivery; 10D00Z0-10D00Z2 for C-section), and revenue codes (0720-0722, 0729). (2) For newborn claims: Continue billing with Z38.x diagnosis codes in primary position on UB-04, paired with revenue codes (0171, 0172, 0173, 0174, 0179, 0723). Update claim validation rules and provider documentation/training materials to reflect these changes. Failure to comply will result in claim denials. Note: The billing team should maintain documentation of claims paid Feb 1-May 8, 2020 for potential auditing purposes, though the state will reprocess denied claims from that period without provider resubmission.