Quick Coding Guide for Breastfeeding Related Services

Sometimes, I don’t have to do any of the work except to make friends and provide attribution.  Today’s installment features a wonderfully concise, helpful guide to CPT coding for breastfeeding related services, care of the National Breastfeeding Center.

Some sample text:

Billing for problems with breastfeeding and lactation is just like billing for any other problem. Using standard evaluation and management codes (E & M) [e.g. Current Procedural Terminology (CPT) codes such as 99212-99215] and diagnosis codes, physicians and other billable licensed practitioners (such as nurse practitioners and physician assistants) may:

  • Code based on time, if greater than 50% of time is spent in counseling, education, or coordination of care
  • Use modifier 25 appended to a problem-focused visit to bill in conjunction with the well baby visit, when there is extended time spent on feeding problems.
  • Bill for care provided for the mother, often as a new patient, in addition to billing for the baby, if history exam, diagnosis and treatment are done for her.

Wow, top-shelf content. Use it.

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