Code This RFA Fetal Reduction C Section Scenario
Question: The patient had a radiofrequency ablation (RFA) fetal reduction of twin A at 18 weeks. At 28 weeks, the patient had a cesarean section, and twin A was delivered en caul, and twin B was delivered healthy. Would you bill the C-section with modifier 22? I have not come across this before, so any thoughts or prior scenarios would be appreciated. Nevada Subscriber Answer: What does your documentation look like? Was the removal of the en caul fetus described as difficult in some way? If very little additional time was required and you have a statement such as “twin A removed without difficulty,” you probably do not have the documentation to support modifier 22 (Increased procedural service) on this claim. Suzanne Burmeister, BA, MPhil, Medical Writer and Editor
