What would I need to code for twin delivery and insurance is Medicaid. How do I code this since it is a fee for service?
Thanks!
| Reporting twin deliveries |
CPT Assistant,
August 2002 Pages: 3,4 Category:
Related Information
Coding for Delivery of Twins
The preferred method of reporting a vaginal delivery of twins, when the global obstetrical care is provided by the same physician or physician group, is by appending modifier '-22' to code 59400,
Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care, or
59610, Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy and/or forceps) and postpartum care, after previous cesarean delivery.
An alternative method of reporting vaginal delivery of twins is with code 59400 or 59610 for twin A, and 59409 or 59612 with modifier '-51' appended for twin B. If both twins are delivered via cesarean delivery, then report code
59510, Routine obstetric care including antepartum care, cesarean delivery, and postpartum care, since only one cesarean delivery is performed. If the cesarean delivery is significantly more difficult, then append modifier '-22' to code 59510. When reporting modifier '-22' with 59510, a copy of the operative report should be submitted to the third- party payer with the claim. If one twin is delivered vaginally and the other by cesarean delivery and the global obstetric care is provided by the same physician or same physician group, then report the global code 59510 or 59618, for the cesarean delivery, and 59409 or 59612, for the vaginal delivery with the '-51' modifier appended. In all of the previously described different scenarios, the
diagnosis code for multiple gestations should be indicated.
Reporting the Global Obstetrical Package
The global obstetrical package is reported when a physician from a solo practice, or the same physician group practice provides the global routine obstetric care, which includes the antepartum care, delivery, and postpartum care. Based upon the type of delivery, vaginal delivery (code 59400), vaginal birth after cesarean (VBAC) delivery (code 59610), cesarean delivery (code 59510), and cesarean delivery after an attempted vaginal delivery after previous cesarean delivery (code 59618), then the appropriate delivery code is reported for the global obstetrical care.
It is not appropriate to report the antepartum, delivery, and postpartum care separately, when the total obstetrical care is provided. However, there are circumstances when the antepartum care or postpartum care is reported separately. Let's review some of these circumstances.