Wiki Weird twin delivery on seperate days!

[tmerickson]

Okay smart people. I need help with this one. Pt has twins, both in their own sac. @ 17 weeks her water breaks with one, but not in labor. They hospital her. 2 days later they decide to close her cervix and at the exam the baby is coming so they deliver baby A (stillborn). They do the cerclage the next day to save baby B. The pt is now on hospital bed rest, and the dr has been rounding on her for 16 days now. How do I code this? I don't even know where to start!

 

[kathyvl74]

prior to 20 wks you can't bill a delivery code, i would bill an e/m code for this stillborn delivery and also for all the other hospital rounding. also bill for the cerclage.

 

[tmerickson]

Thanks

 

[mcdiac]

I recently had a similar situation, but mine was 27 weeks & did survive, so I was able to code a global delivery. Then when Twin B delivers we'll code delivery only charge.

For your situation, I would code a hospital E&M & placental delivery, if it was done.