# Billing twin BPP/NSTs



## hdanner7 (Nov 28, 2012)

Hi-
We have a patient that is pregnant with twins.  She came in for an ultrasound and for Baby A they only did an NST and a limited ultrasound (76815).  For Baby B, they did a Biophysical with NST (76818).  My question is how to bill this.  In single gestation pregnancies, you cannot bill a 76815 and 76818 or 76819 together.  How do I bill for twins when they only do a limited and NST on one baby and a full BPP w/ or w/o NST on the other?

Thanks,
Hope Danner, CPC


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## kvangoor (Dec 4, 2012)

I had this situation come up too. I found that you could put 59 modifiers to avoid the bundling on all these codes. Then, use dx to show there are two diffrent babies being monitored. I used the 651.X and then I also used v91.X. The delivery charges can be doubled this way as well.


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