Wiki Ultrasound for high risk twins

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amiegant2

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Patient presents for an ultrasound of twins; she and twins are considered high risk.
Can I bill for two ultrasounds; do I bill for one with a modifier; if I need a modifier which is appropriate?
 
It may depend on the insurance company.

I usually add 59 because I believe the twins are two separate anatomical sites.(They each have their own anatomy and may have different medical issues). However, BCBS of Kansas is insisting I use modifier 22. I think they want both bundled into one sono with a 22 so they can pay at a lower reimbursment.

Yes, the work is increased, but you still have to view and measure the multiple fetuses as if they are singletons. To me that is more than increased work, it is two separate and distinct procedures.

I also add into 'box 19' notes such as " 59 shows 2nd procedure for 2nd of twin fetuses." I also attach the documentation at that time.
 
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