March 25, 2025
Effective June 26, 2025, we will implement a new Clinical Payment and Coding Policy CPCP043 Lactation Support Services with coding guidance.
CPCP043 provides information on the appropriate billing and coding for lactation support services provided during the antenatal, perinatal, and postpartum time periods.
For more detail, refer to the new policy CPCP043.
Important Reminders
Always check eligibility and benefits first through Availity® Essentials or your preferred vendor portal, prior to rendering services. This step will confirm prior authorization requirements and utilization management vendors, if applicable.
The information provided does not constitute coding or legal advice. Physicians and other health care providers should use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment, and to submit claims using the most appropriate code(s) based upon the medical record documentation, coding guidelines and reference materials.