I know this is probably already billed but I pulled this off of Supercoder and of cIourse it is in icd 9. I don't code babies any longer but do the GYN op note coding. I was intrigued by your questions. This was copied and pasted from a prior question.
2. What if They Come on Different Days?
Occasionally, multiple-gestation babies will be born on different days. For example, a patient is at 38 weeks gestation and carrying twins in two sacs. One membrane ruptures, and the ob-gyn delivers the baby vaginally. Two days later, the second ruptures, and the second baby delivers vaginally as well.
Here, you should report the first baby as a delivery only (59409) on that date of service, Stilley says. For the second, you should bill the global code (59400), assuming the physician provided prenatal care, on that date of service, she adds. "The reason not to bill the global first is that you are still offering prenatal care due to the retained twin.
"I promise that you will have to attach a letter explaining the situation to the insurance company," Stilley points out. "ICD-9 will be important to the payment. Be sure to use the outcome codes" (for example, V27.2).