Routine maternity care/codes
Routine maternity is not a $0-cost-share preventive benefit. Go to the Member Inquiry tool > Additional benefits > Maternity to see the member's routine maternity benefits.
Self-funded plans with a Maternity exclusion for dependents will deny all services except routine lab work listed below.
Bacteriuria screening
Use codes:
- 81000-81003, 87086
Diagnosis codes:
- O07.0-O9a.53
- Z32.01
- Z33.1
- Z34.00-Z37.9
- Z39.0-Z39.2
At 12-16 weeks gestation or first prenatal visit
USPSTF Rating: A
Blood tests
Complete blood count
CPT codes: 85025*, 85027*
Diagnosis codes
- O07.0-O9a.53
- Z32.01
- Z33.1
- Z34.00-Z37.9
- Z39.0-Z39.2
On a routine basis for iron deficiency anemia
Blood typing:
CPT code: 86900*
Diagnosis codes:
- O07.0-O9a.53
- Z32.01
- Z33.1
- Z34.00-Z37.9
- Z39.0-Z39.2
Gestational diabetes screening
CPT codes: 82947, 82948, 82950, 82951, 82952
Diagnosis codes:
- O07.0-O9a.53
- Z32.01
- Z33.1
- Z34.00-Z37.9
- Z39.0-Z39.2
For women 24-28 weeks pregnant and those at high risk for gestational diabetes
USPSTF Rating: B
HRSA requirement
Hemoglobin/hematocrit:
CPT codes: 85014*, 85018*
Diagnosis codes:
- O07.0-O9a.53
- Z32.01
- Z33.1
- Z34.00-Z37.9
- Z39.0-Z39.2
On first prenatal visit
Hepatitis B screening:
CPT codes: 86704, 86340*
Diagnosis codes:
- O07.0-O9a.53
- Z32.01
- Z33.1
- Z34.00-Z37.9
- Z39.0-Z39.2
USPSTF Rating: A
Obstetric panel:
CPT codes: 80055, 80081
Diagnosis codes:
- O07.0-O9a.53
- Z32.01
- Z33.1
- Z34.00-Z37.9
- Z39.0-Z39.2
Priority Health routine pre-natal care as preventive
RBC antibody screen:
CPT code: 86850*
Diagnosis codes:
- O07.0-O9a.53
- Z32.01
- Z33.1
- Z34.00-Z37.9
- Z39.0-Z39.2
Rh compatibility:
CPT code: 86901
Diagnosis codes:
- O07.0-O9a.53
- Z32.01
- Z33.1
- Z34.00-Z37.9
- Z39.0-Z39.2
First prenatal visit and follow up for women at high risk
USPSTF Rating: A
Rubella antibody:
CPT code: 86762*
Diagnosis codes:
- O07.0-O9a.53
- Z32.01
- Z33.1
- Z34.00-Z37.9
- Z39.0-Z39.2
USPSTF Rating: B
Venipuncture:
CPT codes: 36415, 36416
Diagnosis codes:
- O07.0-O9a.53
- Z32.01
- Z33.1
- Z34.00-Z37.9
- Z39.0-Z39.2
Bill with preventive blood studies
Breastfeeding support
Counseling, education code: S9443
Supplies codes:;
- A4281-AA4286
- E0602
- E0603
- K1005
For pregnant and lactating women
USPSTF Rating: B
HRSA requirement
Cervical cancer screening/Pap smear
CPT codes:
- 88141-88155
- 88164-88167
- 88174
- 88175
Diagnosis codes:
- O07.0-O9a.53
- Z32.01
- Z33.1
- Z34.00-Z37.9
- Z39.0-Z39.2
HRSA requirement
Chlamydia testing
CPT codes
- 87110
- 87270
- 87320
- 87490
- 87491
- 87492
Diagnosis codes:
- O07.0-O9a.53
- Z32.01
- Z33.1
- Z34.00-Z37.9
- Z39.0-Z39.2
USPSTF Rating: B
Counseling to reduce risk for post partum depression
CPT codes
- 96127
- 99401-99404
- 99411-99412
USPSTF Rating B
Gonorrhea testing
CPT codes
- 87850
- 87590
- 87591
- 87592
Diagnosis codes:
- O07.0-O9a.53
- Z32.01
- Z33.1
- Z34.00-Z37.9
- Z39.0-Z39.2
USPSTF Rating: B
HIV testing
CPT codes
- 86701
- 86702
- 86703
- 87389
- 87806
HCPCS codes:
- G0432
- G0433
- G0435
Diagnosis codes:
- O07.0-O9a.53
- Z32.01
- Z33.1
- Z34.00-Z37.9
- Z39.0-Z39.2
USPSTF Rating: A
Human Papillomavirus (HPV) testing
CPT codes
- 87623
- 87624
- 87625
Diagnosis codes:
- O07.0-O9a.53
- Z32.01
- Z33.1
- Z34.00-Z37.9
- Z39.0-Z39.2
Prenatal, post-natal and delivery care
CPT codes:
- 59400-59410
- 59425-59515
- 59610-59622
Diagnosis codes not specified
OR
CPT codes:
- 99201-99215
- 99241-99245
Diagnosis codes:
- O07.0-O9a.53
- Z32.01
- Z33.1
- Z34.00-Z37.9
- Z39.0-Z39.2
Priority Health may pay routine pre-natal care as preventive
Cost-sharing applies to global and delivery codes for HSA plans
Syphilis testing
CPT codes:
- 86592*
- 86593*
- 86780*
Diagnosis codes:
- O07.0-O9a.53
- Z32.01
- Z33.1
- Z34.00-Z37.9
- Z39.0-Z39.2
USPSTF Rating: A
Ultrasound
CPT codes: 76801 - 76817
Diagnosis codes:
- O07.0-O9a.53
- Z32.01
- Z33.1
- Z34.00-Z37.9
- Z39.0-Z39.2
Priority Health routine prenatal care as preventive
Vaccinations
No diagnosis codes are specified for vaccinations.
See the preventive vaccines coding table page for coverage information
- Preventive service codes
- Vaccine codes
- Vaccine administration
- Flu vaccines
- Lung cancer CT screenings
- Pelvic & breast exams, Pap tests
- Prenatal & maternity care
- Long-acting reversible contraceptives, Medicaid
- Well-child visits
- Medicare preventive services
Preventive Health Care Guidelines brochure
Key:
* = Test included in OB Panel; screening is typically performed using the OB panel
ACIP = Advisory Committee on Immunization Practices
HHS = Health and Human Services
HRSA = Health Resources and Services Administration
USPSTF = United States Preventive Services Task Force