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Ob-gyn coding presents a lot of coding challenges before you. Sometimes you may find yourself in a fix trying to report twin cesarean delivery. If so, you should take a dig at 59510 with modifier 22 attached. However, that may not always be the case. You will need to adjust your twin delivery reporting depending on an insurance company's preference. So how should you report twin delivery? Whenever a patient has twins, most ob-gyns first make an attempt at a vaginal delivery as long as the physician has not figured out any complications. Here in this situation, you should go for 59400 for the first baby and 59409-51 for the second. Keep this in Remember: Both CPT and the American Congress of Obstetricians and Gynecologists (ACOG) recommend you use modifier 51 (Multiple procedures) for the second delivery. But then you may come face to face with some payers who want to see modifier 59 instead. Other coders report appending modifier 22 to the global delivery (59400) if the patient had more than the average of 13 visits and to account for the second delivery in instances where the payer does not permit separate billing for the additional delivery. When this piece of guidance is in writing, you should follow it. Best option: Send a letter of explanation with the claim to stay away from immediate denial by the claim processor. A simple form letter talking about the high-risk nature of multiple-gestation pregnancies will routinely go straight to medical review and save the hassle of denial resubmissions or lost reimbursement through write-offs. For further details on this and for other specialty-specific articles to assist your ob-gyn coding, sign up for a good medical coding resource like Coding Institute.
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