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Vaginal Twin delivery

  1. Default Vaginal Twin delivery
    Medical Coding Books
    My OB/GYN delivery twins both vaginal. The patient has Medicaid.

    I coded 59410 (for twin A) and 59409/59 (for twin B).

    However Medicaid is deny the 59409/59(twnin B) stating that they have already paid.

    Does anyone know the correct way for billing twin delivery both by vagnial for Medicaid?

  2. #2
    Location
    Tacoma, WA
    Posts
    1,087
    Default
    Quote Originally Posted by spierce View Post
    My OB/GYN delivery twins both vaginal. The patient has Medicaid.

    I coded 59410 (for twin A) and 59409/59 (for twin B).

    However Medicaid is deny the 59409/59(twnin B) stating that they have already paid.

    Does anyone know the correct way for billing twin delivery both by vagnial for Medicaid?
    Did your OB not provide any of the prenatal care? Just wondering why you were not billing 59400 for the first twin with 59409-59 for the second twin. What diagnosis codes are you using? You should have 651.01 and V27.2 on both codes to show a twin delivery. If you are using 59410 because no prenatal care was done, then that part is correct.
    Arlene J. Smith, CPC, CPMA, CEMC, COBGC

  3. #3
    Location
    Cape Girardeau, Missouri
    Posts
    80
    Default Medicaid Twin Delivery
    I also coded my vaginal twin delivery to Medicaid with 59400 and 59409-59 second twin with the twin dx and they denied. I called them and they said they only pay delivery for one when they are both vaginal. No extra money for the extra work. I asked about modifier 22 on the delivery and she said no it would not result in any extra payment. I said I guess the doc can walk out after the first one then and she just laughed. So I guess there is nothing we can do?
    ObCoder MA,BS,CPC

  4. Default
    I believe Texas Medicaid only pays for one delivery, unless the delivery is c-section and vaginal, then you can bill both. But, as I'm unsure of this policy, you might try an appeal. You have correctly submitted the claim with 59410 and 59409.

  5. #5
    Location
    Wausau, WI
    Posts
    57
    Default
    According to CPT Assistant April 1997

    Twin Deliveries:

    Both Vaginal: 59400 and 59409-51

    Assuming the physician provides the pre- and post-natal care.
    Bill the global for the first twin and the delivery only for the second.

    Dx codes should reflect twin gestation.

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