Re: Re: Codes for office [2 Attachments]

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What constitutes a physician? A chiropractor friend and I were thinking about joining forces in her office. She is pediatric certified and I refer to her when I have tongue tie kids or moms with low milk supply. Can she then be the physician? Thanks, Dana Dana Schmidt, BS, RN, IBCLCCradlehold, DirectorBreastfeeding Education & Supportwww.cradlehold.nethttp://breastfeedinghomevisitservices.weebly.com/shop.htmlProviding the minimum amount of intervention for the minimum amount of time for maximum benefit to mother and baby We do not seek to establish any professional relationship with any person or entity as a result of any visit to this Website. Transmission of the information is not intended to create and receipt does not create, a doctor-patient or other professional relationship between you and any medical professional or other individual on this Website. Persons contacting us or any medical professional through this Website should not send personal health, confidential, or sensitive information, and should not ask specific medical questions. The Website is a public forum and any comments that you make or submit to us may be displayed publicly on that forum, so you should be cautious about making such comments. No information

submitted electronically through the Website or email to us will be treated as privileged, confidential, sensitive or personal health information unless we have previously entered into a written agreement with you to protect such information. Any person submitting confidential or sensitive information to us without first entering a prior written agreement with us to protect such information waives all rights to confidential protection or doctor-patient privilege. We assume no responsibility for the loss or disclosure of any information that you transmit to us via the Internet. Please call or visit www.cradlehold.net for an evaluation. Please see the attached should you desire more in-depth lactation advice.Home Consultations Breastfeeding Home Visit Services:The best time to observe a mother and baby is when the baby is ready to nurse. We offer flexible scheduling in order to accommodate your baby's needs. A typical initial evaluation lasts approximately 1-1.5 hours. Appointments can be arranged during days, evenings and weekends. http://breastfeedinghomevisitservices.weebly.com/ From: Judith L. Gutowski

To: Sent: Tuesday, January 24, 2012 10:04 AM Subject: Re: Codes for office [2 Attachments]

, If

you are “employed byâ€

the pediatrician you can see their breastfeeding patients as an “incident – to providerâ€. This

works very well, reimbursement is 100% and can even make money for the practice

if they choose to bill separately for mother and baby. They can at least break

even if only billing for baby, but most still make money. Your physician’s

billing specialist will know what “incident-to†billing is. Attached is the

portion of the CMS manual describing incident-to services. These services can

be furnished by an IBCLC. From the attached

document AAP Coding A. Joint visit

physician and allied health professional: (99212–99215) This is a physician visit which is supported and facilitated by the initial work of the allied health professional.

The latter begins the visit, records the chief complaint, documents the history, establishes key physical

findings, observes and documents the breastfeeding encounter, and counsels the patient about lactation issues related to

the problem. The physician can join the allied health provider,

baby, and mother partway through the encounter and then: 1. Review the history 2. Examine the infant to confirm and/or add to the physical 3. Document in the chart the physician’s physical findings, diagnoses and plans 4. Write any necessary prescriptions. With the help of the allied health provider, physician

time spent on history taking, counseling, and education will

be minimized. History, physical, and medical decision-making

guidelines will be used to decide the level of the visit code

(99212– 99215). Time based coding cannot be used for this visit because the physician will have spent relatively little

time face-to-face with the family. Time based coding is

based specifically on the physician’s time, NOT the

allied health professional’s

time. Judy Judith

L. Gutowski, BA, IBCLC, RLC 135 McGrath Lane P Box 1 Hannastown, PA 15635-0001 Cell

Phone Fax