Wiki ACA and lactation coverage

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tkiehl

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With the ACA stating that all lactation support is covered with no copay, how would we code this to get insurance to cover? We are using 99212-99214 and using 779.31(feeding problems) as diagnosis. These codes automatically process with copay or deductible. Don't feel routine care codes are appropriate as the babies receiving this care are not well. Feeling frustrated! Thanks!
 
Lactation Support

I looked in to this for our practice, and my understanding is that this falls under the mother's benefits. Lactation counseling is available in outpatient clinics, and the claims would be billed through the mother's coverage. Then it's considered a well benefit and paid at 100%.
If done at the peds office, as we do, with a diagnosis like feeding disorder, it is not viewed as routine and subject to any deductibles or copays.
I think I found this on healthcare.gov.
 
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