# C/Section Assist. on /Twins



## drufolo (Jun 13, 2010)

I'm very new to the coding profession but glad to be in it.
When billing a C/S for twins (Primary) 59510-22 (global) and 2nd twin 59514-51 (C/S only) if your Physician for the assist is also with the same practice do you bill the assist the same way?
I know that the assist would be billed with the modifier 80 but should the assist on the 2nd twin be with the modifier 80-51?


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## m.j.kummer (Jun 14, 2010)

According to Ob-Gyn Coding Alert 2008: Volume 11, Number 12 

When the doctor delivers all of the babies, whether twins, triplets, etc., by cesarean, you should submit 59510 with modifier 22 appended. Because the ob-gyn made only one incision, he performed only one cesarean, but the modifier shows that the physician performed a significantly more difficult delivery due to the presence of multiple babies, Zeigman says.

The Assistant surgeon would report 59514-80.

“This can also depend on carrier. For instance, Colorado Medicaid allows you to bill for both babies, even though the physician makes only one incision,” Montoya says.
Be sure to include a letter with the claim that outlines the additional work that the ob-gyn performed to give the carrier a clear picture of why you're asking for additional reimbursement.

You may not get paid but if the service is provided and documentation supports the services provided... bill it.


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## drufolo (Jun 16, 2010)

Thank you


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