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Blue Cross Blue Shield of VermontAll Plans · Billing Codes · Coding · VT · OB-GYNHigh impact

Changes to Global Maternity Care and Delivery Coding

Act
by Aug 31, 2026
Effective date
Sep 1, 2026
Identified
Aug 4, 2026

Summary

Effective September 1, 2026, maternity care billing transitions from global codes to phase-based E/M codes with modifier -TH and pregnancy diagnosis codes. Current global antepartum codes (59425, 59426) will be replaced by individual E/M codes for prenatal visits. A complete transition to granular four-phase coding (antepartum, labor management, delivery, postpartum) occurs January 1, 2027.

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What to do

by Aug 31, 2026 · 10 steps
01Billing team must update billing software and encounter forms to transition maternity coding.
02IMMEDIATE ACTIONS REQUIRED.
03Coding team: Stop using global antepartum codes 59425 and 59426 for dates of service on or after 9/1/2026.
04Billing system: Configure to require modifier -TH on all E/M codes for maternity prenatal visits after 9/1/2026.
05Clinical documentation: Update EMR templates to ensure providers document ICD-10 Z34.XX (pregnancy gestation) or O00-O9A diagnosis codes on all prenatal visit notes.
06Providers and coders: Train on new E/M coding rules requiring documentation of medical decision making (MDM) or time per CPT guidelines.
07For dates of service 9/1/2026 through 12/31/2026: Bill prenatal visits using appropriate E/M code + modifier -TH + Z34.XX or O00-O9A codes.
08Before January 1, 2027: Prepare for phase-based coding system replacement.
09Failure to implement will result in claim denials and revenue loss.
10Reference AMA CPT 2027 Maternity Care Services guidelines for complete specifications.

Codes mentioned

5942559426Z34.XXO00

Original notice

Changes to Global Maternity Care and Delivery Coding
bluecrossvt.org · Always check the source before changing claims.
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Related changes

See all Blue Cross Blue Shield of Vermont changes →
CMO Corner: Important Changes to Global Maternity Care Coding and BillingHighEffective Jan 1, 2027 · CodingContraceptive Counseling ReminderHighNo effective date · Provider NewsGlobal Obstetrics/New Maternity Services CodesHighEffective Sep 1, 2026 · CodingPreventive Care Reminder Sent to MembersHighEffective Dec 1, 2026 · Provider NewsBrowse every Blue Cross Blue Shield of Vermont change in the policy list

Related policy hubs

Blue Cross Blue Shield of Vermont policiesVT policy changesOB-GYNCode 59425Code 59426Code Z34.XXCode O00

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