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The information presented here is not intended to diagnose health problems, breastfeeding problems, or to take the place of professional medical care. If you have persistent breastfeeding problems, or if you have further questions, please consult your health care provider. The DC Breastfeeding Coalition does not share partnership with, or have any vested interest in, any of the businesses that may appear on this site, or sites that may be assessable by links herein contained.

Information for Providers

Patient Education Handouts

Position Statements / Policies

The American Academy of Family Physicians

The American Academy of Pediatrics

The American College of Nurse-Midwives

The American College of Obstetricians and Gynecologists

The American Dietetics Association

The Association of Women’s Health, Obstetric, and Neonatal Nurses

The Association of Women’s Health, Obstetric, and Neonatal Nurses - Newborns & Neonates

The National Association of Pediatric Nurses Practitioners

The National Association of Pediatric Nurses Practitioners - NAPNAP Position Statement on Breastfeeding (PDF)

The World Health Organization

For more detailed information about coding for breastfeeding management, please consult the AAP pamphlet Breastfeeding and Lactation: The Primary Care Pediatrician’s Guide to Getting Paid.

The information below is modified with permission from the AAP Breastfeeding and Lactation: The Pediatrician’s Pocket Guide to Coding.

Commonly used ICD-9-CM Codes Related to Breastfeeding

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Feeding Problems
Feeding problems or vomiting, newborn779.3
Feeding problem, infant (>28 days)783.3
Vomiting, infant (>28 days)787.03
Breastmilk jaundice774.39
Neonatal jaundice774.6
Pretem jaundice774.2
Weight and Hydration
Dehydration, neonatal775.5
Weight loss783.21
Slow weight gain, failure to thrive783.41
Rapid weight gain783.1
Infant Distress
Fussy baby780.91
Excessive crying780.92
Infantile colic or intestinal distress789.07
Gastrointestinal Issues
Change in bowel habits787.99
Abnormal stools787.7
High-arched palate750.26

Billing for the Infant’s Mother

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The medical provider may bill for the mother if s/he takes the mother’s history, examines the mother’s breasts and nipples, observes a feeding and makes a diagnosis and treatment plan for her.

The mother’s insurance may require a request from her primary health care provider. The mother may be billed as either a new patient visit or a consult (99241-99245) if you have a request and provide a written report back to the requestor.

Breast Issues
Abscess, breast675.14
Blocked milk duct675.24
Breast engorgement, ductal676.24
Burning pains, hyperesthesia782.0
Ectopic or axillary breast tissue757.6
Mastitis, infective675.14
Mastitis, interstitial675.24
Other specified nipple, breast anomaly757.6
Other specified nipple, breast infection675.84
Burning pains, hyperesthesia782.0
Nipple infection675.04
Nipple, cracks or fissures676.14
Nipple, sore676.34
Retracted nipple, postpartum676.04
Impetigo (staph), nipple684
Candidiasis, nipple or breast112.89
Agalactia, failure to lactate676.44
Lactation, delayed676.84
Lactation, suppressed676.54
Other specified disorders of lactation676.84
Supervision of lactationV24.1
Other specified follow-up exam
(when original reason for visit has resolved)

Prenatal Discussion about Breastfeeding

Prenatal breastfeeding education:

  • has the biggest effect of any single intervention on improving breastfeeding initiation and duration rates

Medical providers’ attitudes about breastfeeding:

  • significantly impacts breastfeeding rates
  • if medical providers have a positive attitude and encourage breastfeeding, mothers are much more likely to initiate breastfeeding

How to talk to pregnant mothers about breastfeeding

There are many effective methods to educate mothers prenatally about breastfeeding including structured group and individual classes.

Brief prenatal discussions using the “Best Start” technique also have been shown to increase breastfeeding rates.

  • If you are an OB/GYN, you can use the “Best Start” technique during a prenatal visit
  • If you are a pediatrician, you can use this interviewing technique during either a prenatal visit with the family or when you notice a mother is pregnant during a sick or well child appointment with one of her other children.

Best Start Technique:

  1. Ask:
    • Ask open-ended questions such as “What have you heard about breastfeeding?” instead of “Are you going to breast or formula feed?”
  2. Acknowledge:
    • Acknowledge the mother’s specific concern.
    • If she says she heard “breastfeeding hurts” then acknowledge her concern by saying “so, you’re concerned that breastfeeding is going to hurt you.”
  3. Advise:
    • Advise the mother specific to her concern.
    • For example, you could tell her that “you may feel discomfort for the first week or two when the baby first starts nursing, but breastfeeding should not be painful. Many women don’t get the help they need after the baby is born, so the baby doesn’t latch-on correctly. If your baby is in the correct position and opens his/her mouth widely, breastfeeding should not hurt. It is important to get help in the hospital from someone knowledgeable about breastfeeding and see your pediatric provider a few days after you leave the hospital”

It would be ideal to also discuss with the family the importance of:

  • The baby breastfeeding as soon after birth as possible (preferably in the first hour).
  • Avoiding supplementation with formula unless medically indicated.
  • Knowing the signs of adequate milk intake.

Your role as a medical provider is crucial in promoting and supporting breastfeeding.

Provider Letter for Employers

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