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Wiki Twin Delivery - Complicated

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ktrenkle

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I have a patient that was pregnant with twins and her water broke at 35 weeks. She went to our hospital and the midwife delivered the first baby (Baby A) vaginally. The second baby (Baby B) ended up being delivered via C-Section by the M.D. I know one will be global and the other delivery only, but what modifiers would you use to get both claims paid since there are two different providers? Thanks in advance for any help you can give.
 
Depends on the insurance company's multiple birth guidelines; some payers don't want/need a modifier as long as you have the appropriate twin (O30.0-) diagnosis code with Z37.2 outcome diagnosis. Some payers want a modifier 51 while others want a 59.

If you are going to use a modifier use it on the 'delivery only' code. You do not need one for the global code.

Make sure you are billing the c-section as the global delivery and the vaginal delivery as delivery only.
 
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