Insurance to pay for your pump- For Breastfeeding Moms/Issue

Recovering from birth & months of Hyperemesis, encompassing post-partum concerns such as nutritional and physical recovery from HG, breastfeeding support, and infant medical issues stemming from HG (infant reflux, feeding issues, prematurity, etc.).

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Insurance to pay for your pump- For Breastfeeding Moms/Issue

Postby tgger007 » Jan 14, 2009 2:26 pm

we did a lot of research with the pump for Aidan. Doing so, I learned a lot about different ways insurances will pay for a breast pump. This also worked with supplies needed. May 2008 I did the research.

Here are the codes and websites that can help. ... _a/124.htm

Codes the insurance company's use to bill:

ICD-9 Codes Related to Breastfeeding

Your doctor uses ICD-9 Codes when communicating your diagnosis to the insurance company. Being able to identify which ICD-9 Code matches your situation can help when proving that your pump is medically necessary.

Diagnosis Code

Twin pregnancy post-partum condition or complication 651.04
Abscess of nipple 675.03
Infections of nipple 675.04
Abscess of breast 675.1
Nonpurulent mastitis 675.2
Other specified infection of breast and nipple 675.8
Unspecified infection of the breast and nipple 675.9
Retracted nipple 676
Cracked nipple 676.1
Engorgement of breasts 676.2
Other and unspecified disorder of breast 676.3
Suppressed lactation 676.5
Other disorders of lactation 676.8
Unspecified disorder of lactation 676.9
Dermatitis contact 692


Cleft palate/lip 749
Abnormal tongue position 750.1
Down’s syndrome 758
Neonatal candida infection 771.7
Breastmilk jaundice 774.39
Other transitory neonatal 775.5
Feeding problems in newborn 779.3
Abnormal loss of weight 783.2
Feeding difficulty – infant 783.3
Failure to thrive 784.4
Dysphagia 787.2
Suck reflex abnormal 796.1

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Postby OlisMommy » Jan 14, 2009 6:12 pm

I formula feed, but having these ICD-9 codes could be priceless as some docs dont want to figure them out. The right one v. the wrong one can make a huge difference.
HG 5wk-34wk (aka:birth) I had it bad, we almost died. I did everything but the NJ. I do NJ in my line of work. I can tell you all about them except how they feel. ER/Trauma/ICU RN PM me anything.
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Postby eliana1300 » Jan 14, 2009 8:13 pm

Very interesting. Just curious: all the ICD-9 codes have to do with breast issues (sorry, duh moment but hear me out). My problem was retained placental fragments and I don't see a code for that. Any info? I would like to try to give my next child (in about 5-20 years) breastmilk.
1st pg = HG 8 weeks to c-section delivery due to breech presentation--D&C at 4 months PP for retained placenta
2nd pg = HG from 6 weeks up to 7 months--scheduled c-section
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Postby tgger007 » Jan 26, 2009 5:45 pm

I've not found any codes for that. I'll look around more.

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Postby tmijs789 » Dec 01, 2009 4:54 pm

Interesting how once you learn some of the codes used by insurance companies you can word things just the way necessary to get covered on things. Reminds me of lawyers.
Independent Health Insurance article provided by The Pajama-Man School
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Postby shamsuthbegum » Jan 19, 2010 8:07 am

Thanks for all your posting....
Its very clear and interesting to read..
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