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Wiki Non-global Twin C/S Coding

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AubreyB

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I work at an OB-Gyn clinic in Alaska and we have been having trouble coding twin C/S deliveries. We do not bill globally, and yet all of the reference material I have found says to use the global code for a twin C/S delivery (both twins delivered via C/S). Does anyone else out there not bill global maternity and can provide some insight? Thank you!
 
If your clinic did not provide all prenatal care, and you have to split the billing, then you bill the 59514 or 59515 for the twin C/S delivery. Usually. Most insurance carriers won't pay for delivery of the second babe when both are delivered via C/S. If both are delivered vaginally, or if one is vaginal and one is C/S, then you can bill 2 delivery codes, but most carriers feel the amount of work involved in delivering the 2nd babe via same C/S incision as the first is not significant enough to warrant separate reimbursement.

Check your carrier guidelines, though. I have one carrier here in Colorado that will pay for that 2nd C/S delivery, but most carriers won't. If the additional work was significant, I have to go with a modifier 22 on the 59514/59515 code, then appeal it when we don't get any extra reimbursement, and THEN argue with the claims processor who denied my appeal as a duplicate claim. But maybe that's just me. ;-)

Becky, CPC
 
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