One global with a 22 modifier. Here's an excerpt I've saved from an OB-GYN Coding Alert article regarding multiple births:
• Myth #5: 2 C-Sections Mean 2 Codes.
The ob-gyn delivers twins by cesarean. Although you may be tempted to report two codes for two c-sections, you would risk over-reporting your ob-gyn's work.
Reality: When the doctor delivers all of the babies — whether twins, triplets, or more — by cesarean, you should submit 59510-22 (Increased procedural service). The reason you report only one code is that the ob-gyn is only making one incision, says Christine DuBois, CPC, coding coordinator for Western Mass Physician Associates in Chicopee, Mass.
Highlight: The ob-gyn performed only one cesarean, but modifier 22 shows that the ob-gyn performed a significantly more difficult delivery due to the presence of multiple babies. Important: "You will need supporting documentation," DuBois says.
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