Commercial

Medical Policy

Policy Attachment

Attachment to Policy #

00.10.38a

Attachment:

Policy #:

00.10.38a

Description:

CODING SCENARIOS FOR REPORTING HIGH-ORDER MULTIPLE (TRIPLETS, QUADRUPLETS, ETC) BIRTHS WHEN ROUTINE OBSTETRIC (GLOBAL MATERNITY/OBSTETRIC [OB]) CARE WAS PROVIDED

Title:

Billing Requirements for Multiple Births for Professional Providers

EXAMPLES OF CODING SCENARIOS FOR DELIVERY OF HIGH-ORDER MULTIPLES
WHEN ROUTINE OBSTETRIC (GLOBAL MATERNITY/OBSTETRIC [OB]) CARE WAS PROVIDED

This attachment describes examples of coding scensarios for reporting high-order multiple (triplets, quadruplets, etc.) births when routine obstetric (global maternity/obstetric [OB]) care was provided by the same provider or provider group. 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 B: Examples of Coding scenarios for Reporting Twin Births when Antepartum Care was not 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), the babies were delivered vaginally
Partially Completed VBAC refers to a multiple birth where, after a previous C-section(s), a minimum of one baby was delivered vaginally and a minimum of one baby was delivered by C-section
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
All Vaginal	Baby A	59400
	Baby B	59409	Modifier 59
	Baby C	59409	Modifier 59

All C-Section	Babies A, B, C, etc.	59510	Modifier 22

Completed VBAC	Baby A	59610
	Baby B	59612	Modifier 59
	Baby C, etc.	59612	Modifier 59

Attempted VBAC	Babies A, B, C, etc	59618	Modifier 22

Partially Completed VBAC	Baby C: C-Section	59618
	Baby A: Vaginal	59612	Modifier 51
	Baby B: Vaginal	59612	Modifier 59
	OR
	Babies B, C, etc: C-Section	59618	Modifier 22
	Baby A: Vaginal	59612	Modifier 51

C-Section & Vaginal	Baby C: C-Section	59510
	Baby A: Vaginal	59409	Modifier 51
	Baby B: Vaginal	59409	Modifier 59
	OR
	Babies B, C, etc: C-Section	59510	Modifier 22
	Baby A: Vaginal	59409	Modifier 51

Version Effective Date:

12/30/2019

Version Issued Date:

12/30/2019

Version Reissued Date:

5/15/2024

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