Proper Reporting for Medical Billing of Twins Delivery

If you have a medical billing claim to process that includes twins delivery and one was a traditional birth and the other a cesarean, you should report two codes. If both babies were delivered traditionally (vaginally), report only one code for both babies, as it will be considered one procedure.

If there are no complications, the babies will both be born vaginally. You should report 59400 (Routine obstetric care including antepartum care, vaginal delivery [with or without episiotomy, and/or forceps] and postpartum care) for the first baby and 59409-51 (Vaginal delivery only [with or without episiotomy and/or forceps]; multiple procedures) for the second baby.

Your diagnosis code will be 651.01 (Twin pregnancy; delivered, with or without mention of antepartum condition) and V27.2 (Twins, both live born). Be wary of using modifiers, especially 51 and 59. There will be a difference among carriers which one they prefer when reimbursing medical billing claims.

If the birth was vaginal and cesarean, you should choose two codes. The solution would be found in 59510 (Routine obstetric care including antepartum care, cesarean delivery, and postpartum care) for the second baby and 59409-51 for the first. Bill the cesarean first because it is a higher RVU (relative value units).

View all Articles by: Melissa Clark, CCS-P