Billing for c section pregnancy complicated monochorionic/monoamniotic twin pregnancy with acardiac twin (TRAP sequence)

[MaureenDL123]

Hello,

This is a completely new scenario for me, and I am unsure how I should code for the delivery.

27w6d with MCMA twins, acardiac of twin B (TRAP sequence), FGR of twin A w/ elevated UA dopplers, being delivered for PEC w/ SF w/ worsening LFTs

A c section was performed at 27 weeks due to PEC w/ SF w/ worsening LFTs

Twin A viable Male, twin B non viable with significant malformations, TRAP sequence, FGR

Codes O43.022, O14.12, Z3a.27, how would you code the outcome, Z37.3
Would you bill the c section with or without the modifier 22?

Thank you for your help.

 

[nielynco]

Hello,

This is a completely new scenario for me, and I am unsure how I should code for the delivery.

27w6d with MCMA twins, acardiac of twin B (TRAP sequence), FGR of twin A w/ elevated UA dopplers, being delivered for PEC w/ SF w/ worsening LFTs

A c section was performed at 27 weeks due to PEC w/ SF w/ worsening LFTs

Twin A viable Male, twin B non viable with significant malformations, TRAP sequence, FGR

Codes O43.022, O14.12, Z3a.27, how would you code the outcome, Z37.3
Would you bill the c section with or without the modifier 22?

Thank you for your help.

Your diagnostic choices are correct. If she was seen more frequently during the pregnancy for the PEC and the delivery was more difficult than usual, you should certainly consider adding a modifier -22 to the code. But be sure the documentation is there for consideration.

 

[MaureenDL123]

Thank you so much!