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Ob-Gyn Coding Alert

Reader Question:

Use Only 1 Code for Twins Via C-Section

Question: If the physician delivers twins via cesarean section, should we report 59510 and 59514?

Illinois Subscriber Answer: You should not report twin delivery via cesarean with 59510 (Routine obstetric care including antepartum care, cesarean delivery, and postpartum care) and 59514 (Cesarean delivery only). There is only one incision, and therefore the ob-gyn performs one cesarean. If the cesarean was more difficult than usual because of the presence of twins, triplets, etc., you can add modifier  -22 (Unusual procedural services) to 59510. But be sure to include your documentation when submitting this claim to explain the additional work involved.
If the physician delivers the twins vaginally, you can report two vaginal deliveries with 59400 (Routine obstetric care including antepartum care, vaginal delivery [with or without episiotomy, and/or forceps] and postpartum care) and 59409-51 (Vaginal delivery only [with or without episiotomy and/or forceps]; multiple procedures), according to the American College of Obstetricians and Gynecologists.