Tackle Twin Amniocentesis Challenge

Published: 30th June 2010
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As an ob-gyn coder, you will face various coding challenges. For instance, you may be bowled over by questions such as this:

Question: I know we can report amniocentesis for twins by different ways, based on CPT Assistant. I have heard the best way is to report amnio twice if the ob-gyn needed to use two sticks; or else, we should simply append modifier 22. However should we report two units of 76946 when we report only one unit of 59000 for twins?

Well, you should report ultrasound guidance only once (76946, Ultrasonic guidance for amniocentesis, imaging supervision & interpretation), as your ob-gyn uses it throughout the whole procedure. Even if the ob-gyn did two amnios, you'll still report the guidance only once.

In some examples, twins can have two amniotic sacs. When that's the case, you may opt for 59000 (Amniocentesis; diagnostic) twice, one time for each sac. If the twins are same (share the amniotic sac), then you can go for 59000 only once.

Note of caution: You shouldn't add modifier 22 (increased procedural service) to a single amnio procedure, even with twins. You may add modifier 22 to 59000 in these circumstances: your ob-gyn carried out an amniocentesis on two amniotic sacs and the payer rejects billing 59000 twice the ob-gyn has documented important increased work owing to the presence of twins, or the patient has a higher multiple gestation pregnancy.

For more answers to your ob-gyn queries such as this and to get access to CPT Asssistant and all CPT Assistant back issues, sign up for a one-stop medical coding guide and enjoy hassle-free coding.

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