C section Delivery of Twins after RFA Twin A

[MaureenDL123]

Hello,

This is a new one for me. Patient had an RFA fetal reduction of Twin A at 18 weeks. At 28 weeks patient had a c section and twin A was delivered encaul, and twin B was delivered, healthy. Would you bill the c section with modifier 22 as 1 was liveborn and the other would stillborn with Z37.3? I have not come across this before, so any thoughts or prior scenarios would be appreciated.

Thank you so much!

 

[nielynco]

Hello,

This is a new one for me. Patient had an RFA fetal reduction of Twin A at 18 weeks. At 28 weeks patient had a c section and twin A was delivered encaul, and twin B was delivered, healthy. Would you bill the c section with modifier 22 as 1 was liveborn and the other would stillborn with Z37.3? I have not come across this before, so any thoughts or prior scenarios would be appreciated.

Thank you so much!

What does the documentation look like- was the removal of the encaul fetus described as difficult in some way? If very little additional time was required and you have a statement such as "twin A removed without difficulty" I would not think you have the documentation to support a modifier 22.

 

[MaureenDL123]

Thank you so much, I apologize for the late reply.