I have this note in my book, probably from some teaching by Laureen!
For twins: both delivered by CS: 59510.
However, Supercoder.com has article that says add modifier 22 if the physician has documented significant additional work for the delivery.
Multiple by cesarean delivery: When the doctor delivers all of the babies, whether twins, triplets, etc., by cesarean, you should submit 59510.Don't forget: "You should add modifier 22 to 59510," says Jenny Baker, CPC, professional services coder at the Center for Womens Health in Portland, Oregon, if the physician has documented significant additional work for this delivery. Because the ob-gyn made only one incision, he performed only one cesarean, but the modifier shows that the physician performed a significantly more difficult delivery due to the presence of multiple babies. Be sure to include a letter with the claim that outlines the additional work that the ob-gyn performed to give the carrier a clear picture of why you're asking for additional reimbursement.
If that wasn't an option on the multiple choice test...(59510-22) you are faced with choosing the best possible answer. Writing the test author is probably a good thing to do!