# Twin C-section delivery



## kenbeckman (Dec 30, 2010)

I seem to be getting different opinions and not sure which is correct. Some say to bill the global OB with C/S code 59510 then bill the C/S only code with the 51 modifier for second baby. This does not seem right since only one C/S was performed. Others state bill only the global code with a 22 modifier for the unusual circumstances. Does anyone know if there is a correct position on this issue? Thanks.


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## bonzaibex (Dec 30, 2010)

One global with a 22 modifier.  Here's an excerpt I've saved from an OB-GYN Coding Alert article regarding multiple births:

• Myth #5: 2 C-Sections Mean 2 Codes.
The ob-gyn delivers twins by cesarean. Although you may be tempted to report two codes for two c-sections, you would risk over-reporting your ob-gyn's work. 
Reality: When the doctor delivers all of the babies — whether twins, triplets, or more — by cesarean, you should submit 59510-22 (Increased procedural service). The reason you report only one code is that the ob-gyn is only making one incision, says Christine DuBois, CPC, coding coordinator for Western Mass Physician Associates in Chicopee, Mass. 
Highlight: The ob-gyn performed only one cesarean, but modifier 22 shows that the ob-gyn performed a significantly more difficult delivery due to the presence of multiple babies. Important: "You will need supporting documentation," DuBois says. 

Becky, CPC


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