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Wiki Coding for twins

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dofran51

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How would you bill for twins, vaginal or C/S, would you use X2
I need help on coding for twins for Medicaid Texas. Vaginally and C/S.
 
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Twins

It depends on how twins are delivered - vaginally, c/s, one of each, etc. ACOG has recommended if both are delivered vaginally and you have seen mom for the entire pregnancy, bill 59400 for one unit and 59409-59 for the second.
Teresa Keith
North Georgia Women's Center
 
If twin A is delivered vaginally and twin B is delivered by cesarean section, bill the cesarean as 1st code, 59510 with vaginal only 59409-59 as secondary code. We have had to fight welfare to receive payment for both but have won at fair hearing.

Cheryl A. Lewis, CPC, CPC-I
 
If I recall correctly. Texas Medicaid will only reimburse for one delivery. I can't recall if you can challenge an appeal or not. The correct way is to bill 59515 for twin A, then 59409-59 for the other twin.
 
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