Ob-Gyn Coding Alert

Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.
Question: What is the correct way to code amniocentesis for twins? Should I use 59000 with a 2 multiplier? Similarly, how should I report 76946 for ultrasonic guidance? Ohio Subscriber
Answer: If the ob-gyn inserts the needle for the amniocentesis twice, you should report 59000* (Amniocentesis; diagnostic) twice. Append modifier -59 (Distinct procedural service) to the second code. If the physician inserts the needle only once, report 59000 appended with modifier -22 (Unusual procedural services). Regardless of the number of needle insertions, the ob-gyn performs ultrasound guidance only once. Therefore, you should code it using 76946 (Ultrasonic guidance for amniocentesis, imaging supervision and interpretation).