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Wiki coding nsts for twins to medicaid

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crevoet

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can anyone help me with coding for nts for twins to medicaid; I have tried billing 59025-26 modifier on the first line with 59025-26 & 59 on the second line. I have also tried billing the nst 59025-26 x2. Now they are saying to use a different modifier possibly 76.
 
I bill to Medicaid for NST's often and occasionally for twins. As of Jan. 1, 2013, we have -been billing:
59025-26(twin A) and 59025-26-59 (twin b). This would be for a single NST performed on that date of service.
If there are two NST's performed on the same date of service, we use:
59025-26 (twin A - am NST), 59025-26-59 (twin b - am NST), 59025-26-76 (twin a - pm NST), and 59025-26-59-76 (twin b - pm NST). This is assuming the same dr. performed all services. If a different provider performed the 2nd NST of the day, you would use -77 modifier instead of -76.
We still have to ask for reconsiderations from time to time, but this seems to be accepted readily. Hope that helps.

Sheri K
 
I do these regularly. I think it helps to include in "box 19" a note. For example: 59 shows 2nd procedure was performed on 2nd of twin fetuses. They twin DX codes rarely get looked at.
 
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