Wiki Vbac for twins

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yuditheravila

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Hi guys !!
Please i study x cpc test a question about the vbac code x twins,

problem:
26 year old gravida 2 para 1, 36th week of pregnancy with twin gestation monochorionic and monoamniotic.
Pt had previous cesarean during first pregnancy, physician allowed her to attempt vaginal birth.
After 3 hours pt exhausted taken to the or x cesarean delivery. Two healthy newborns were born. Same physician provided postpartum care to the mother.

There are three different answers on it. Which one is it? Why???

1- 59618-22 .....
2- 59618, 59618-51 .....
3- 59618, 59620-51 .....

Thanks x some help
 
When billing a multiple birth you bill the first baby with the global delivery code and the second baby with a delivery only code. Now which answer matches that parameter?
 
Correct answer is number 1. In twin c/s deliveries you bill the one code since there is only 1 cut made to deliver both babies. 22 mod is for the extra work both in prenatal care and delivery.
 
This is out of BCBS instructions, I have found this same instruction at other carriers as well as the CPT Assistant.
• If one or more newborns are delivered vaginally and subsequent newborn(s) are delivered Cesarean, use the appropriate Cesarean delivery code (usually 59510 or 59618) for the Cesarean delivery and the appropriate Cesarean delivery-only code (59514 or 59620) for each subsequent newborn. (Append with modifier -59)
• The primary procedure will be allowed at 100% of the contracted rate, subject to the member’s contract benefits.
• The secondary procedure(s) will be allowed at 50% of the contracted rate for each newborn, subject to the member’s contract benefits.
 
Thanks Mitchell, but I am confused yet. This question I think has some many explanations!!?? Do you know if there is any guideline that explain exactly this one??
 
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