Hi Debbie - I work in a midwives office where we have a breastfeeding clinic 
as a sub-part of the office. We bill the mom as a routine maternity care 
visit, but not rolled in with the global pregnancy charge. Even if she is 
within her 6 week period, we have been successfully generating a separate 
bill for the lactation service. However, the clincher is that a billing 
provider (in our case, a midwife) needs to see each patient along with the 
lactation service provider. So, typically we see the patient for 45 minutes 
or so, then the midwife comes in at the end to discuss the care plan 
(typically about 5 minutes) then we wrap up with the patient. There is a 
list of lactation codes that can be used (I don't have in front of me, but 
maybe someone else can help me with where they're from - they're from a 
lactation textbook). There are codes for mothers and infants, and we are 
only able to use the maternal codes (for example, if the infant is 
tongue-tied, we have to bill for the effects on mom - sore nipples, nipple 
trauma, low milk supply, etc). There is one code (676.94) that encompasses 
general lactation problems, then a bunch of more specific ones, including 
nipple pain, mastitis, "suppressed lactation", and a host of other versatile 
options. We can only bill for the amount of time the billing provider 
actually spends with the patient, so mostly we are billing level 2 visits, 
but can do a level 3 if the provider examines more than 2 systems and writes 
a prescription.
I spoke to another LC at ILCA who was having similar success billing through 
a pediatric practice, so there are certainly ways around it. Our only 
limitation right now is that we can't generate a separate bill if the mom 
comes in to see us on the same day as her 6 week follow-up - can't have 2 
visits with the same provider on the same day, and there's only one MW in 
the office each day.

I can get you more specific info when I'm at the office tomorrow, so email 
me if you need more - but it can be done!

Kirsten Berggren, PhD, CLC

 Date:    Mon, 20 Aug 2007 18:54:51 -0400
> From:    Debbie Mitchell <[log in to unmask]>
> Subject: billing code question
>
> How would you bill for lactation services in a obstetrician's office?  I =
> am an=20
> IBCLC who has been offered a position as a lactation consultant in an=20
> obstetrician's office, but they may need to rescind the offer if we can't=
> figure=20
> out how to bill the insurance company for lactation consultation services=
> .  If=20
> any of you work in an obstetrician's office or gynecologist office, pleas=
> e help=20
> me with the billing process.  We are wondering about insurance codes, and=
> =20
> how do you bill for lactation services when the mother's pregnancy and 6 =
> will=20
> postpartum care are all bundled together in one price?  Please help!!
>

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
Mail all commands to [log in to unmask]
To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or [log in to unmask])
To unsubscribe: unsubscribe lactnet or ([log in to unmask])
To reach list owners: [log in to unmask]