I had a thought or two on asking for public donations to fund lactation
services in a hospital. If a hospital wishes to provide a professional service to
its patients it has the capacity to bill insurers for the service. What did the
billing department in this hospital do to secure reimbursement for lactation
services? Do they track claims and follow-up on the ones that are denied? Did
they bother to contact each insurer and ask how to code for these services?
There are a number of codes that are being reimbursed for in-patient lactation
services. We do not need a specific lactation code, although there are specific
S codes for lactation services that can be used. A hospital uses a UB-92 form
that requires revenue codes. Two that are receiving reimbursement are 231 for
incremental nursing charges (nursing services in addition to room and board)
and 940 (other therapeutic services).

Many hospitals negotiate rates with insurers that include lactation charges
in a bundled package, rather than charging separately. Some not for profit
hospitals even provide lactation services as part of their service and duty to the
community!

Marsha Walker, RN, IBCLC
Weston, MA

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