Wiki twin delivery, 2 providers question

[rhosrenolo@gmail.com]

We had a twin vaginal delivery that was done by 2 doctors. Doctor A delivered baby A liveborn. 2 hours later Doctor B delivered baby B demised along with both placentas.

I'm not sure too sure how to code this. I was originally thinking of billing 59409 for doctor A and 59400 for doctor B, reason being the patient was still going through labor. However I've read somewhere, and I can't find the source now, that I should bill the global 59400 to doctor A because they delivered the live baby, and 59409 to doctor B instead. Have any of you encountered this scenario? Any thoughts or assistance will be a great help.

 

[nielynco]

We had a twin vaginal delivery that was done by 2 doctors. Doctor A delivered baby A liveborn. 2 hours later Doctor B delivered baby B demised along with both placentas.

I'm not sure too sure how to code this. I was originally thinking of billing 59409 for doctor A and 59400 for doctor B, reason being the patient was still going through labor. However I've read somewhere, and I can't find the source now, that I should bill the global 59400 to doctor A because they delivered the live baby, and 59409 to doctor B instead. Have any of you encountered this scenario? Any thoughts or assistance will be a great help.

So are both physicians in the same practice or are they not affiliated? If in the same practice you just bill globally and pick the provider who was assigned as her primary when she entered the practice as the billing practitioner. But as the work was delayed and more complicated than a normal delivery I would add a modifier -22 to the global code. You would assign credit for the work for each provider as an internal process (but not via billing). If they are unaffiliated, you can only bill globally for the provider's practice that provided all of the global care. The unaffiliated provider will bill only 59409 for their work.

 

[rhosrenolo@gmail.com]

So are both physicians in the same practice or are they not affiliated? If in the same practice you just bill globally and pick the provider who was assigned as her primary when she entered the practice as the billing practitioner. But as the work was delayed and more complicated than a normal delivery I would add a modifier -22 to the global code. You would assign credit for the work for each provider as an internal process (but not via billing). If they are unaffiliated, you can only bill globally for the provider's practice that provided all of the global care. The unaffiliated provider will bill only 59409 for their work.

They are both in the same practice. I'll add mod 22 to the global code.
Thank you Neilyn for your reply. Much appreciated.