# lactation consult billing



## astough (Jan 16, 2015)

I work in an ob/gyn practice with a lactation consultant that educates our patients on breastfeeding during their pregnancy and post partum. Can anyone help me with icd-9 codes for "prenatal" lactation consults? No problems, just education. I am doubting that this is even reimbursable but I would like to try. Also, would 98960 be an appropriate cpt code? Any help is appreciated.


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## asehr (Apr 14, 2015)

Have you been able to find any more info re: lactation consult billing? One of our RN's does lactation consults for our post partum patients and she insists we should be billing the insurance, however all info I have seen states the patient must have a problem which has been documented by a physician in a previous encounter. I don't think insurance companies will pay for this also, but without any codes I am unable to verify that.


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## lmiller1233 (Jun 6, 2016)

Hi, 

Im late, new member... Anyway I'm new to the industry however I work for a pediatric office and I am heavily involved in charge entry. Insur. companies will pay for the lactation codes however some insur. companies do not pay for prolonged visits 99354 for breast feeding. The dr. has to document feeding issues(prior enctr) and recommend a consult with the lactation consultant. If I'm not mistaking, lactation visits are time based. They will pay for the first half hour but anything over 55 mins (prolonged visit) some insur. companies will not pay even with modif. 25.


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