All PlansBilling CodesHigh impact
Adaptive Maintenance (new and revised codes) Addition
Blue Cross Blue Shield of Vermont·VT · OB-GYN·Newsletter
Effective date
Sep 1, 2026
We identified it
Jun 27, 2026
Summary
Blue Cross VT released four new CMS codes (G0681, G0682, G0683, G0684) retroactive to January 1, 2026, which are considered informational. Additionally, maternity care billing is transitioning from global obstetric codes to new maternity services codes effective September 1, 2026, requiring E/M codes with modifier -TH and specific ICD-10-CM Z34A codes for prenatal visits. Claims prior to September 1, 2026, must continue using current antepartum codes 59425 and 59426.
Action Required
By September 1, 2026: Billing team must implement two critical changes: (1) Update billing software to recognize new G-codes G0681, G0682, G0683, and G0684 as informational codes retroactive to January 1, 2026—review any claims submitted from January 2026 forward and resubmit if necessary; (2) For all prenatal care on or after September 1, 2026, discontinue using global obstetric codes 59425 and 59426 and transition to billing with E/M codes appended with modifier -TH, along with ICD-10-CM Z34A codes (with required 4th character for gestation level). Before September 1, 2026: Providers must ensure medical records document medical decision making (MDM) or time consistent with CPT guidelines to support E/M billing. Claims for prenatal care prior to September 1, 2026, must continue using codes 59425 (4-6 visits) and 59426 (7+ visits) under the current global package. Failure to implement the modifier -TH requirement and Z34A codes after September 1, 2026, will result in claim denials. Update encounter forms and EMR templates to prompt for gestational age documentation.