Ob-Gyn Coding Alert

Question: Recently, my ob-gyn's patient delivered twins. My physician delivered the first twin, but a second physician had to be called in to do the second delivery. Can we bill for the second physician also?

Illinois subscriber

Answer: The answer depends on the relationship between the two physicians and whether your carrier allows you to report the global code, even if the physician did not do both deliveries.

If both physicians do not share an affiliation and the second physician intends to bill for the delivery, you should report 59426 (Antepartum care only; 7 or more visits) and 59410 (Vaginal delivery only [with or without episiotomy and/or forceps]; including postpartum care) for the first physician's work.

The second physician will report the delivery only (59409, Vaginal delivery only [with or without episiotomy and/or forceps]).

If both physicians share an affiliation, you can report the entire global procedure and then split out the work of the two physicians internally.

Also, you could try to report the delivery code only (59409) with modifier -62 (Two surgeons).

However, this option does not work often, but some carriers may agree to pay for the procedure as 59426, 59409-62, 59430 (Postpartum care only [separate procedure]) for the first physician and 59409-62 for the second physician.