Ob-Gyn Coding Alert

Question: I know to bill 59850 for the delivery of twins (both nonviable) 19-4/7 weeks, but should I bill this once or twice with modifier 51 for twin "B?"

California Subscriber

Answer: You won't find any specific guidelines in CPT for this issue, because at that age, each fetus is very small. Your best bet may be to add modifier 22 (Increased procedural services) to 59850 (Induced abortion, by one or more intra-amniotic injections [amniocentesis-injections], including hospital admission and visits, delivery of fetus and secundines). The reason is that the ob-gyn is not really repeating 59850 twice, only a small part of it.