Elisheva rightly asks,

<< Jan, for those of us outside of the quasi-medical world, who generates
these
 codes?  Are they insurance/compensation related, or medical per se? Because,
 while I agree with Rachel that letting the medical model take over lactation
 would be problematic, surely letting insurance companies decide what LC's are
 competent to do is stretching things too far!
  >>

They are determined by the American Medical Association, with (probably)
input from the other disciplines such as pediatrics, obstetrics, and so on.
I took the diagnoses I listed directly off the pediatric "superbill" which is
what insurance companies must have before they will reimburse the pediatric
practice at all.  Unfortunately IBCLCs cannot generate their own set of codes
and expect to be paid by insurance companies.  Won't work.

As far as insurance companies determining what IBCLCs are competent or not to
do -- hey -- they make those determinations all the time with physicians,
with what medical tests you can and cannot have, with the length of time you
can stay in the hospital, with which specialist you may or may not see, with
what treatments you may or may not have.   Why should we be any different?

Jan B -- now old, snarky, AND cynical in Wheaton

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