According to Ob-Gyn Coding Alert 2008: Volume 11, Number 12
When the doctor delivers all of the babies, whether twins, triplets, etc., by cesarean, you should submit 59510 with modifier 22 appended. Because the ob-gyn made only one incision, he performed only one cesarean, but the modifier shows that the physician performed a significantly more difficult delivery due to the presence of multiple babies, Zeigman says.
The Assistant surgeon would report 59514-80.
â€śThis can also depend on carrier. For instance, Colorado Medicaid allows you to bill for both babies, even though the physician makes only one incision,â€ť Montoya says.
Be sure to include a letter with the claim that outlines the additional work that the ob-gyn performed to give the carrier a clear picture of why youâ€™re asking for additional reimbursement.
You may not get paid but if the service is provided and documentation supports the services provided... bill it.
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