Pat Lindsey, IBCLC - Lactation Visit Receipt Packet
What is in the Packets?
There are TWO different packets to choose from to best suit your practice needs.   
Each packet contains the ICD-10 Lactation Visit Receipt (superbill) & 37 page Guide Booklet as well as all forms for  outpatient lactation private practice or outpatient clinic .

Portion of sales goes to the Licensure and Reimbursement Committee of USLCA

 DELUXE PACKET - $90.00
Deluxe Packet includes LVR and several business forms in PDF FILLABLE FORMS* which can be filled in digitally on your computer, ipad, tablet or other electronic device with Adobe Reader:
Lactation Visit Receipt with ICD-10 Codes (superbill) with customized header (no logos) - in both fillable PDF form or in PDF to use for printing as NCR forms
Important Business Forms with customized headers (no logos) with PDF FILLABLE FORMS* can be filled out on your computer, ipad, tablet or any electronic device with Adobe Reader are included for Breastfeeding Questionnaire, Consent and Financial Form, Documentation Forms & Telephone Triage Forms
Several other must have business forms such as HIPAA Privacy Practice form, HIPAA fax form, referral forms, and others in WORD templates for you to customize to suit your
An Instructional Guide for the ICD-10 Lactation Visit Receipt
Many other resources both to educate you and help you to advocate for your profession
* PDF FILLABLE FORMS (only the following are fillable PDF forms:
Breastfeeding Questionnaire
2 Consent Form & Financial Form (one for in-network and one for not in-network with insurance company)
Documentation Forms (First time visit documentation form and follow-up visit documentation form)
Telephone Triage Forms


 REGULAR PACKET - $75.00
Regular Packet includes:
Lactation Visit Receipt with ICD-10 Codes (superbill) with customized header (no logos) - in a PDF for printing as NCR forms
An Instructional Guide for the  ICD-10 Lactation Visit Receipt
Many other resources both to educate you and help you to advocate for your profession
All Business Forms in WORD templates for you to customize to suit your practice:
Breastfeeding Questionnaire
Consent and Financial Form
Documentation Forms
Telephone Triage Forms
HIPAA Privacy Practice form
HIPAA fax form
Referral forms,
       and others in WORD templates for you to customize to suit your practice

2002-2016@Pat Lindsey, IBCLC - Lactation Visit Receipt