# Complicated Delivery



## linda s (Jul 11, 2008)

The CPT guidelines state that delivery services include management of uncomplicated labor and delivery.  Can anyone tell me what may be considered a "complicated" delivery and when it would be appropriate to use the modifier -22 to the delivery charge?
Thank you.


----------



## cedwards (Jul 21, 2008)

Some senarios I have come across that would be appropriate to use 22 modifier with complicated delivery are...

Repair of thrid and fourth degree lacerations. (You append -22 to delivery code)

Manual extracition of placenta

Twin c-section delivery Report 59510 with -22 modifier.  

Be sure to include a letter to your payer with claims that you are billing the -22 modifier explaining the additional work and why an increased payment is deserved.


----------

