Ob-Gyn Coding Alert

Question: What is the correct way to bill for delivery (either vaginal or c-section) for twins? Arizona Subscriber Answer: Your answer depends on the delivery method. Multiple vaginal: For vaginal births, you should report 59400 (Routine obstetric care including antepartum care, vaginal delivery [with or without episiotomy, and/or forceps] and postpartum care) for the first baby and 59409- 51 (Vaginal delivery only [with or without episiotomy and/or forceps]; Multiple procedures) for the second. Good advice: Send a letter of explanation with the claim to avoid immediate denial by the claim processor. A simple form letter explaining the high-risk nature of multiple-gestation pregnancies will routinely go straight to medical review and save the hassle of denial resubmissions or lost reimbursement through write-offs. First vaginal, second cesarean: If the physician delivers the first baby vaginally but the second by cesarean, assuming he provided global care, report 59510 (Routine obstetric care including antepartum [...]