ajijon
Networker
Hey all,
What procedure code would be utilized for breast feeding home visits?
What procedure code would be utilized for breast feeding home visits?
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Wiki Breast feeding home visit cpt code?
- Thread starter ajijon
- Start date
airart
Guru
Is this an education visit or is milk from a bank?
You didn't specify if this was an education visit for the mother or if a milk based product from a bank was being used by a nurse to give to the infant. I found some info that might help you. S9443 is used for a Lactation Consultation. Medicare does not cover this, however some state Medicaids do. Rhode Island does, but Texas does not.
Medicaid and CHIP Information:
Link: http://www.medicaid.gov/Medicaid-CH...ds/Lactation_Services_IssueBrief_01102012.pdf
The following provides examples of different codes that States use for billing and receiving federal matching funds for coverage of lactation services:
Lactation Consultation (face-to-face visit), HCPCS code S9443 - S9443 - LACTATION CLASSES, NON-PHYSICIAN PROVIDER, PER SESSION
Postpartum Care and Examination of Lactating Mother, ICD-9 code V24.1
Manual Breast Pump purchase, CPT Code E0602
Hospital Grade Electric Breast Pump rental, CPT Code E0604
Individual Electric Breast Pump purchase, CPT Code E0603
Example of State Benefit Package (Rhode Island)
Lactation Support – Home -
Covered benefit – prior approval required. Initial consult must occur within first two weeks of delivery. Benefit limited to 2 additional visits within first month after delivery
You didn't specify if this was an education visit for the mother or if a milk based product from a bank was being used by a nurse to give to the infant. I found some info that might help you. S9443 is used for a Lactation Consultation. Medicare does not cover this, however some state Medicaids do. Rhode Island does, but Texas does not.
Medicaid and CHIP Information:
Link: http://www.medicaid.gov/Medicaid-CH...ds/Lactation_Services_IssueBrief_01102012.pdf
The following provides examples of different codes that States use for billing and receiving federal matching funds for coverage of lactation services:
Lactation Consultation (face-to-face visit), HCPCS code S9443 - S9443 - LACTATION CLASSES, NON-PHYSICIAN PROVIDER, PER SESSION
Postpartum Care and Examination of Lactating Mother, ICD-9 code V24.1
Manual Breast Pump purchase, CPT Code E0602
Hospital Grade Electric Breast Pump rental, CPT Code E0604
Individual Electric Breast Pump purchase, CPT Code E0603
Example of State Benefit Package (Rhode Island)
Lactation Support – Home -
Covered benefit – prior approval required. Initial consult must occur within first two weeks of delivery. Benefit limited to 2 additional visits within first month after delivery
ajijon
Networker
The billing would be done for a lactation specialist for breastfeeding education classes done at the patients home. Would the S9443 Hcpc code be the one to utilize? The states she works in is NJ and NY.
Thanks for your help.
Thanks for your help.
airart
Guru
Lactation Services NY/NJ
I found this on NY State Medicaids website. This document has some changes that begin April 1 and May 1, 2013. This is in PDF format and gives you the codes to use.
http://www.health.ny.gov/health_care/medicaid/program/update/2013/march13_mu.pdf
Here is another link about FAQs for these services.
http://www.ilca.org/files/USLCA/Com...bursement FAQ Article for USLCA 6-2012 v2.pdf
Couldn't find anything specific for New Jersey other than they do cover lactation counseling and by the same professions that New York as listed. Should be good to bill the S9443, it is the recommended code listed by CMS.
Link: http://www.state.nj.us/health/fhs/wic/documents/forprofclincarebreast.pdf
First page, last column, very bottom asterick - lactation consultant or physician with specialized lactation counseling training, such as FABM, or AAP CBC.
I found this on NY State Medicaids website. This document has some changes that begin April 1 and May 1, 2013. This is in PDF format and gives you the codes to use.
http://www.health.ny.gov/health_care/medicaid/program/update/2013/march13_mu.pdf
Here is another link about FAQs for these services.
http://www.ilca.org/files/USLCA/Com...bursement FAQ Article for USLCA 6-2012 v2.pdf
Couldn't find anything specific for New Jersey other than they do cover lactation counseling and by the same professions that New York as listed. Should be good to bill the S9443, it is the recommended code listed by CMS.
Link: http://www.state.nj.us/health/fhs/wic/documents/forprofclincarebreast.pdf
First page, last column, very bottom asterick - lactation consultant or physician with specialized lactation counseling training, such as FABM, or AAP CBC.