Twins, vaginal delivery global question

[desireewhite185@yahoo.com]

We had a patient deliver twins vaginally. Our midwife delivered one of the babies and then our physician delivered the other. Our physician also had to use JADA system for PPH. The physician wants global billing for the second baby and the midwife global for the other, as they did shared care. Is this possible? We are in the same group so I feel like I cannot give each one of them a global charge. I would have to do 59400 for one of them and then 59409, 51 for the other is my understanding. For the JADA system I can bill the unlisted 59899, $734 RVU 2.76 (comparing to 59160).
Just wanted to confirm I cannot bill global twice, even though two different clinicians delivered. Thanks, Desiree

 

[nielynco]

We had a patient deliver twins vaginally. Our midwife delivered one of the babies and then our physician delivered the other. Our physician also had to use JADA system for PPH. The physician wants global billing for the second baby and the midwife global for the other, as they did shared care. Is this possible? We are in the same group so I feel like I cannot give each one of them a global charge. I would have to do 59400 for one of them and then 59409, 51 for the other is my understanding. For the JADA system I can bill the unlisted 59899, $734 RVU 2.76 (comparing to 59160).
Just wanted to confirm I cannot bill global twice, even though two different clinicians delivered. Thanks, Desiree

Per ACOG, if you are dealing with a twin delivery, you code 59400 and 59409-51 for the second one. As these two practitioners are in the same practice with the same tax ID, the payer bill not reimburse any differently. You may not charge a global fee for both providers. As to JADA system, you are correct to use 59899 and compare the work to 59160.