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Published
Notification
Billing Requirements for Multiple Births for Professional Providers
Notification Issued Date:
MPNotificationDescriptionPub
This version of the policy will become effective 12/30/2019. The policy has been reviewed and updated to communicate the Company's continued position on Multiple Births.
Policy Attachment
Attachment to Policy #
00.10.38a
Attachment:
B
Policy #:
00.10.38a
Description:
MULTIPLE BIRTH CODING SCENARIOS FOR DELIVERY OF TWINS WHEN ANETEPARTUM CARE IS NOT PROVIDED
Title:
Billing Requirements for Multiple Births for Professional Providers
MPNewsFLASHPub
MPBodyPub
EXAMPLES OF CODING SCENARIOS FOR DELIVERY OF TWINS
WHEN ANTEPARTUM CARE WAS NOT PROVIDED
This attachment describes examples of coding scenarios for reporting twin births when antepartum care was
not
provided by the same provider or provider group that delivers the neonates. For other examples of coding scenarios for multiple births, refer to the following policy attachments:
Attachment A:
Examples of Coding Scenarios for Reporting Twin Births when Routine Obstetric (Global Maternity/Obstetric [OB]) Care was Provided
Attachment C:
Examples of Coding Scenarios for Reporting High-Order Multiple (Triplets, Quadruplets, etc.) Births when Routine Obstetric (Global Maternity/Obstetric [OB]) Care was Provided
Attachment D:
Examples of Scenarios for Reporting High-Order Multiple (Triplets, Quadruplets, etc.) Births when Antepartum Care was not Provided
AS USED IN THIS TABLE:
Baby A
refers to the first neonate delivered. Baby B, C, etc. refers to subsequently delivered neonates
.
VBAC
refers to a vaginal birth (delivery) after a previous cesarean (C-section) delivery
Completed VBAC
refers to a a multiple birth where, after a previous C-section(s), both babies were delivered vagianlly
Attempted VBAC
refers to, after a previous C-section, a vaginal delivery was attempted but not successful and, therefore, the babies were delivered by C-section
THE CODING SCENARIOS IN THIS TABLE ARE EXAMPLES AND DO NOT REPRESENT A COMPREHENSIVE LIST OF PROCEDURE CODE AND MODIFIER COMBINATIONS (THIS TABLE DOES NOT REPRESENT A COMPREHENSIVE LIST OF CODE COMBINATIONS)
Delivery Type
Baby
Code
Modifier
Both Vaginal
Baby A
59409
Baby B
59409
Modifier 59
OR
Baby A
59410
Baby B
59409
Modifier 59
Completed VBAC
Baby A
59612
Baby B
59612
Modifier 59
OR
Baby A
59614
Baby B
59612
Modifier 59
Both C- Section
Babies A & B
59514
Modifier 22
OR
Babies A & B
59515
Modifier 22
C-Section & Vaginal
Baby B: C-Section
59514
Baby A: Vaginal
59409
Modifier 51
OR
Baby B: C-Section
59515
Baby A: Vaginal
59409
Modifier 51
Attempted VBAC
Babies A & B
59620
Modifier 22
OR
Babies A & B
59622
Modifier 22
Version Effective Date:
12/30/2019
Version Issued Date:
12/30/2019
Version Reissued Date:
5/15/2024
Claim Payment Policy Bulletin
Commercial
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