Wiki lactation consultation

[jbhuju]

hello all,
i do have a question regarding coding and billing for lactation consultation BY CLC ( certified lactation consultation) . how do we bill that. i did few research and found that we can bill as S9443, 98960, 99401-99404 or 99241-99245 but could not get exact answer. please help.
thank you

 

[AmandaBriggs]

You'll need to reach out to your payers to see which codes they recognize for this service. Our facility primarily uses 99401-99404 and S9443. Some payers have policies on lactation counseling on their websites, others we had to reach out to individually.

 

[SuFra21]

Is the CLC an RN? Our office has an RN, NP and DO who are all certified. I am having an issue finding the correct codes to use for the RN's services since she does not have an NPI and is not a billable provider.

 

[tloeb]

You'll need to reach out to your payers to see which codes they recognize for this service. Our facility primarily uses 99401-99404 and S9443. Some payers have policies on lactation counseling on their websites, others we had to reach out to individually.

Amanda, this is a new service we are providing in our outpatient OB/GYN/Midwife clinic by a CLC and have found the codes you mention are what most of our payers accept. I have an additional question regarding supplies used by the lactation consultant. She would like to be able to charge for the supplies, ie: Nipple Shields, Supplemental Nursing System, Breast Shells. When these services were provided in the hospital they discontinued charging for the supplies as it was lumped into a global fee for the lactation services. Do you charge for any supplies that are used by the lactation consultant? I am trying to find the appropriate HCPC code for these and so far have only found A4281: Tubing for breast pump, replacement A4282: Adapter for breast pump, replacement A4283: Cap for breast pump bottle, replacement A4284: Breast Shield and splash protector for use with breast pump, replacement A4285: Polycarbonate bottle for use with breast pump, replacement A4286: Locking ring for breast pump, replacement. Of course these are not descriptive of the supplies she uses.