Dear Debra and Kirsten,
Don't know if this will help, but in building the new program at the
hospital at which I am employed, I called all over creation trying to get
those questions answered. Others who have longer experience at this may be
more informative, but what we ultimately decided is that our inpatient
service was free-of-charge, as are our support groups. Post Partum
follow-up is by phone, but for other visits there is a charge. There were
too many ramifications/liabilities to "carry-over" once the patient was
discharged. Consequently a patient can self-appoint, and self-pay. We
(business office and our central scheduling department) do help screen for
potential coverage by insurances, recognizing that most will not cover or
reimburse (grrrrr). We do advise the clients up front that they may end up
with a charge. We poured over ICD and CPT codes, ultimately deciding to
obtain a "request for consult" from our OB-GYNs, (did not use my
credentials--fraught with landmines here) and gearing the visit to the
mother. As one group suggested, make your codes look like Emergency Room
codes--sprained ankles, broken arms--or in other words "broken
suckers/broken breasts". Still in its infancy, it seems to be working.
I'm sure you've already considered discussing this with your revenue
integrity manager/representative, coders, and your patient access director,
but just in case--they can be incredibly helpful.
Hope some of this (sorry so long) is useful. All of you are helping me
immeasurably.
~Linda M. Duce RN, CNM Lactation Program Coordinator Austin, TX
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