C Section Delivery Of Twins

This is the Recent Photo Graph of Ram-Lakshman. Now These two children ...

Ob-gyn coding: Polish up your twin delivery, ultrasound coding

Are you aware how to report ultrasounds and different-day deliveries? If not, you are not alone. Here our experts provide you with all the answers you need to get the most out of your multiple-gestation claims.

Issue 1: Determine different-day delivery coding strategy Oftentimes, multiple-gestation babies will be born on different days. For instance, a patient is at 38 weeks gestation and is carrying twins in two sacs. While one membrane ruptures, the ob-gyn delivers the baby vaginally. A couple of days later, the second ruptures and the second baby delivers vaginally as well.

Solution: You should report the first baby as a delivery only on that date of service. For the second, you should bill the global code (59400) on that date of service, assuming the doctor provided prenatal care. The reason behind not billing the global first is that you are still offering prenatal care owing to the retained twin.

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Source: http://www.articlesbase.com/medicine-articles/ob-gyn-coding-polish-up-your-twin-delivery-ultrasound-coding-3317260.html

Frequently Asked Questions

    Is it possible for a woman to have a C-Section and Vaginal delivery at the same time - like when having twins?
    A client asked me if it was possible for a woman in the case of having twins or more to deliver one child Vaginally and then the 2nd child C-Section. And yes they understand its not common

    • ANSWER:
      Yes, this can happen. If first baby is born vaginally, and then the second twin turns into a transverse position, a c-section might be called for.

    what are the possible risks of getting pregnant with twins just after 5 months of having a c-section delivery?

    • ANSWER:
      Based on my experiences having any type of pregnancy before 1 yr after a c-section is risky especially twin pregnancies. The uterus needs time to heal itself. You run a risk of what is called uterine rupture where the uterus becomes too thinned out and detaches and opens at the previous c-section suture line. This is considered a medical emergency, and 99% of the time causes excessive bleeding in the mother often requiring a blood transfusion. For the fetus it can causes sever hypoxia (lack of oxygen) sometimes ending up in fetal demise. If uterine rupture does occur the number one priority is to stabilize mom and deliver the baby. Stabilizing mom can be any treatment from blood transfusions to total hysterectomy. My advice is wait about 7 more months. If that is not possible your OBGYN will keep a very close watch over you, and may even send you to see a high risk specialist. Good Luck!

    Very nervous about planned c-section for twins?
    So our doctor told us theres no way we can have a vaginal delivery with our twin boys (currently 33w 5d) so we planned a c-section for jan 12th.. I'm scared to death!! We have an appt to discuss the whole c-section surgery on Monday but I'm curious to hear from other moms how their c-section went and what kind of recovery time to expect. I'm afraid I'm going to panic on the table and need to be sedated! Not looking forward to being "cut up". My first pregnancy was a singleton vaginal delivery no problems (other than pushing for more than 2 hours) but this entire pregnancy obviously has been so different and delivery via c-section is uncharted waters!

    • ANSWER:
      I was in labor both times, so I went in to be observed to make sure I was in labor before they did the c-section.

      When they decided to do it, here's what happened: (by this time, I was wearing ONLY a gown and socks, btw)

      A bunch of nurses start coming in and out. One took some blood, one gave me the sour stuff (anti nausea meds) to drink, and they all asked the same 10ish questions over and over (my birthday, my due date, my ssn, which baby this was, bla bla bla).

      Then I WALKED to the OR-- very strange, I expected to be wheeled. DH was given scrubs to change into and told to wait in the hall until he was called in.

      While I was in the OR, I sat sideways on the table while the anesthetician started scrubbing up my back for the spinal. Then they tell you to take a deep breath and you feel the beesting-- it's the numbing agent. Then you have to bend over as far as possible and hug your belly and hold your breath while they do the actual spinal. That takes a bit of time, like 10-15 seconds, so it's weird to hold that still for that long. I was leaning against a nurse, since DH was still not allowed to come in.

      Quickly after the spinal, they have you lay down on the table as the spinal acts very fast. Then they cover your hair and put up a sheet in front of you (sometime around here they insert the catheter, but I don't know exactly when because I didn't feel it.) It's blue, as they tell you anything blue is sterile and can't be touched. Then they check to make sure you're numb and start cutting.

      About this time they let DH in, and he stood by my head (refusing to look, but I had requested a mirror so I could see). I did get a little nauseous and gag a little, so they put the kidney-shaped pan near my head, but I didn't ever puke either time. I watched in the mirror while they got down to my baby (who was footling breech-- when they got to him all I could see was his a$$, it was so funny). I watched them pull him out, heard him cry, they held him over the sheet, and then took him over to the side to weigh and clean him up and give him the eye drops, all the bracelets and anklets, and do footprints (bring your baby book, they'll do your footprints right there in the OR if you ask), then bundle him up and hand him to DH. At this point they were pulling out my placenta and doing the cord blood donation stuff, and the tugging does make you more nauseous. Then they sewed me up and massaged my uterus and stuff for the next 30ish minutes.

      I was wheeled down the hall to the recovery room with the baby in the basinet (hospital rules, you can't carry him). When we got there I was given some ice chips because I was super thirsty but not allowed to drink. They gave DS his bath, and I was able to nurse him (actually I think I nursed first, then bath). Then he passed out and both DH and I were exhausted (DS1 was born at 12:10am, and DS2 at 1:35am, so middle of the night babies). We got back to the room around 4am with DS2, and tried to sleep (actually DH crashed right out, but I couldn't sleep).

      Then comes recovery-- not that bad, don't let people scare you. but do get up and moving asap, otherwise the gas pains are horrible. Oh, and good luck with that first poop, it's a doozy!

      Don't be scared, I enjoyed both of my c-sections and am looking forward to my third.

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