The Lactation Decision Tree will help facilitate the correct choices for a patient's work through.
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Regular Appt-
Appt made ahead and put on schedule -
Applies to non-PPC pt. as well
| YES
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OK to see pt. Can use Consultation Code if insurance will allow. Document in appropriate chart (either Mother or Baby)
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NO
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Was baby seen by provider, same day (for sick reason)?
| YES
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Do feeding concerns lie with the mother?
| YES
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Can be seen by Jessica same day - no modifiers needed - Use "Mother"Dx codes for billing and chart in "Mother's" chart
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NO
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NO
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Was mother seen by OB and referred?
| YES
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Be aware of potential billing issues if mother was seen same day as Jessica. Bill under the baby, if possible
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Feeding concerns with the baby?
| YES
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Can be seen same day but need modifier 25 as well as specific Dx, not used by previous provider
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NO
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Has a provider specifically requested a Consult for the Mother?
| YES
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Check Ins. coverage - if allowed, a Consult code can be used with the proper "paper trail" - written request, followed by written report back to requesting provider
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NO
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Has the provider specifically requested a Consult for the baby?
| YES
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Check Ins. coverage - if allowed, a Consult code can be used with the proper "paper trail" - written request, followed by written report back to requesting provider
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