kkaye4416
Guest
- Messages
- 1
- Location
- New Brighton, MN
Does anyone know how to bill out for a Lactation Consultant for pediatrics practice? Please if someone could advise I would appreciate it.
Thanks
Thanks
-
If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..
Lactation Consultant - pediatrics practice
- Thread starter kkaye4416
- Start date
TheresaMacRae
New
- Messages
- 3
- Location
- Kennewick, WA
Is this a nurse? Does he or she have the lactation consult credentials? All of the webinars and education I have found looks like it is pretty payer specific. Some options to check are S9443, 99211, 98960,96150 + HCPC supply codes for the breast pumps and replace parts: E0602, E0603, A4284.
- Messages
- 62
- Location
- Hemlock, MI
confused
The question we are having, is if we are billing this to the baby or the mother.... and if it is to the mother, will that cause a problem with the supervising physician being a pediatrician?
The question we are having, is if we are billing this to the baby or the mother.... and if it is to the mother, will that cause a problem with the supervising physician being a pediatrician?
nancydavenport
New
- Messages
- 2
Billing for lactation consulting
Did anyone ever find an answer out to billing for a lactation consultant?
Did anyone ever find an answer out to billing for a lactation consultant?
Cynthia Hughes
Expert
- Messages
- 473
Lactation counseling
From what I have seen, you really must check the policies of the individual payers. The mother is usually the patient and should receive services as a preventive health benefit if the plan is not grandfathered under the ACA. Be aware that some plans are bundling the breastfeeding support to preventive E/M and routine postpartum visits and not really providing benefits for the breastfeeding support. However, some plans very specifically cover the services and list qualifications of the provider of lactation counseling services.
Example: https://www.tricare.mil/CoveredServices/IsItCovered/BreastfeedingCounseling
It's not much help but what I have been able to find. The question of care by the pediatrician is one that is also dependent on each payer's claims adjudication system edits (ie, whether it pairs patient age with physician specialty).
Best wishes,
Cindy
From what I have seen, you really must check the policies of the individual payers. The mother is usually the patient and should receive services as a preventive health benefit if the plan is not grandfathered under the ACA. Be aware that some plans are bundling the breastfeeding support to preventive E/M and routine postpartum visits and not really providing benefits for the breastfeeding support. However, some plans very specifically cover the services and list qualifications of the provider of lactation counseling services.
Example: https://www.tricare.mil/CoveredServices/IsItCovered/BreastfeedingCounseling
It's not much help but what I have been able to find. The question of care by the pediatrician is one that is also dependent on each payer's claims adjudication system edits (ie, whether it pairs patient age with physician specialty).
Best wishes,
Cindy