Dear ones,

I got a copy of the article that Andrew referred to in a post a week or so ago
about peds offices being reimbursed for LC services.  (Article was in
Pediatric Coding Alert).

In essence, the new person at our peds office that is looking into coding
issues, etc., stated that the way the billing is being done at one of the
offices (billing an LC visit under the doctor's name using a CPT code of 99214
-- which is office medical services, established patient, detailed) is
insurance fraud, because the coding book states it MUST be a detailed visit,
face to face with the physician or a nurse practitioner or a physician's
assistant.

Now, do any of you have any other information (either office or in private
practice) about billing as an IBCLC using the CPT codes as are found on the
super-bill?

Obviously, LCs who are in private practice, if they are billing under these
codes -- and these are the only codes I know of -- are they/we committing
insurance fraud by using these codes?  What else can we use?

Anyone have any ideas?

Jan Barger -- feeling as though she just got hit by the book.