Wiki Question on coding twin delivery where one baby delivered at home

[jmacy3879]

Hi
Has anyone had a scenario or advice on coding a non-global twin delivery where one baby delivered at home and the second in the hospital?? Recommendations on coding? Do I bill the 59409 for delivery of twin baby that was born in hospital and 59414 for placenta only of the first baby?

 

[nielynco]

Hi
Has anyone had a scenario or advice on coding a non-global twin delivery where one baby delivered at home and the second in the hospital?? Recommendations on coding? Do I bill the 59409 for delivery of twin baby that was born in hospital and 59414 for placenta only of the first baby?

I would opt for 59409 with a modifier -22 if there were in fact 2 placentas that were delivered and the work involved in removing at least one of them was significant. I have been present when the second placenta just plopped out with no effort so the work will determine if you get additional payment.