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Billing Lactation Visit

  1. #1
    Smile Billing Lactation Visit
    Medical Coding Books
    WE have a lactation consultant in our OB practice. She recently handed me billing sheet for one of our private patient whom she saw for about and hour. She billed a 99215 for this visit. I want to know if this is correct or if anyone else out their can let me know how the bill for lactation visit's.

    Your help would be greatly appreciated.

  2. Default
    It seems like she may be billing based upon time. Time may be used as the key component for selecting an E/M level if the following conditions are met:

    The provider documents total time and suggests tthat counseling or coordinating care dominated more than fifty-percent of the encounter.

    Documentation may refer to: prognosis, differential diagnosis, risks, benefits of treatment, instructions, compliance, or risk reduction.

    The documentation must indicate: the total time, the content of counseling and/or coordination of care, and that over half of the time was spent counseling and/or coordinating care.

    One example is to write something to the effect of, "spent ____ mins of ____ mins counseling (or coordinating) care as documented above".

    If all of these conditions are met, then time may be used to select an E/M level. 99215's time condition is 40 minutes, so if her documentation supports it then it should be ok.

    Hope that helps.


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