Adaptive Maintenance (new and revised codes) Addition

IMMEDIATE ACTIONS: (1) Billing team must review and document the new informational codes G0681, G0682, G0683, G0684 (retroactive to January 1, 2026) in billing system reference materials. (2) BY SEPTEMBER 1, 2026: Providers and billing staff must transition maternity billing for all first prenatal visits after pregnancy confirmation to use E/M codes appended with modifier -TH plus appropriate ICD-10 Z34A code (4th character required for gestation) instead of global codes. (3) Update billing software validation rules to require modifier -TH and Z34A codes on all prenatal claims dated on or after September 1, 2026. (4) Remove automatic use of CPT 59425 and 59426 for dates of service after September 1, 2026. (5) Educate providers and clinical staff that subsequent antepartum visits must use E/M code with modifier -TH and that medical record documentation must support MDM or time per current CPT guidelines, or claims will be denied. (6) For claims before September 1, 2026, continue billing with current antepartum codes 59425 (4-6 visits) or 59426 (7+ visits) and global package rules. Claims submitted with incorrect coding post-September 1 will be denied for non-compliance.