In a message dated 6/25/2001 8:45:13 PM Eastern Daylight Time,
[log in to unmask] writes:
<< I was wondering about coding for billing. For example: a physician sees =
a newborn and finds breastfeeding difficulties (maybe slow to gain =
weight, failure to thrive, etc) and refers the patient to me. I observe =
the feeding technique, correct any incorrect positioning, etc, and offer =
suggestions. I also follow-up. Is this additional service charged in =
your practices? Or just part of the office visit? Is there a code for =
lactation counseling? I haven't located a specific code for lactation =
counseling or teaching. >>
I have posted a few times before regarding my position in a peds office
setting as an IBCLC,RN and every patient I see gets a visit by the MD also ,
who concurs with my care plans. We decided in our office that we get better
reimbursement from insurances. But it is not all the same "numbers/coding
dance" for every insurance. The appeals process for the varying insurances
is incredibly time consuming, although my office has gotten pretty good at it
and knows what codes are better used for which insurance. Any way the basic
CPTcode is 99358 which is a prolonged evaluation and management service that
physicians can use. Another is 99215 is called an "office visit
extended-established patient", and 99205 for a new pt.
Some diagnostic codes I use are feeding difficulty (779.3), other lactation
issues(V24.1), and/or jaundice or reflux, if indicated. My boss also writes
off alot of the lactation service - it really is such a marketing tool for
him and the practice, since parents really do come to us because of the LC
help that is provided.
Hope this is helpful in some way.
Sincerely,
Holly McClain,RN,IBCLC
Chevy Chase, MD
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