Wiki Billing for Breastfeeding consult

[cyates]

I have questions about billing CPT codes for our RN that is a certified Breast Feeding Consultant and has her own Medicaid number and NPI. We are billing her visits under the physician but only bill a 99211 whether the visit is billed under the mother or the baby. I have heard of other practices that are doing this but since they are billing under the physician they are billing higher level E&M codes, mostly 99213 and 99203. Is this legal? Thanks!

 

[thomas7331]

E&M codes other than 99211 require a face to face service by the physician or NPP. Billing an RN service with a higher level E&M code than 99211 would be incorrect coding, unless your payer has specific guidelines or contractual language in place that allows it.

 

[absolutebest]

i use 99401-99404 depending on the amount of time is spent with patient.

 

[nadineguiliano]

This is an ICD-10 issue: I am struggling with an internal med doc who billed Z39.1 Lactating mother. I can NOT find guidelines on this code at all. Everything I encounter is in the setting of consult or assistance with lactation. Is it appropriate to bill for this without ever addressing any issues pertaining to lactation?
Patient was being see in laboratory followup and this was added to the claim. Any advice and i where did you find your information regarding guidelines for this.