When babies can't eat well, it's stressful for everyone involved. Breastfeeding parents may have painful, damaged nipples. Babies may not transfer milk efficiently and may have difficulty growing. Milk supply may be impacted. Bottle feeding babies may leak milk or be unable to create adequate suction. Our feeding evaluations are meant to address parent- and baby-side challenges. We work in concert with IBCLCs (lactation consultants), occupational therapists, physical therapists, and the baby's primary care provider.
Tongue and Lip Ties
Many people are referred for feeding evaluation because their provider suspects a tongue or lip tie. Here are the phases of the hour-long visit:
Gathering information by asking questions and listening to your story.
Examining the baby by feeling their suck and inspecting their mouth, then weighing the baby to see how they've been growing.
Make a recommendation in terms of procedure(s) or other plans. Review the procedure(s), aftercare, keeping baby comfortable, and follow up.
Do the procedures right there in the room. You can watch -- or not. Baby comes immediately to you afterwards and eats.
We only do procedures when it is appropriate -- when we can identify the problem and when we are reasonably certain that it will be beneficial to the baby or the nursing pair to do so.
Please call your insurance to verify coverage before scheduling.
Procedure (CPT) code for tongue tie release: 41010
Procedure (CPT) code for lip tie release: 40819
Diagnosis code: Q38.1 (tongue tie) and/or Q38.0 (lip tie)
Physician: Elias Kass, ND, tax ID 27-3741565, NPI 1245546100
Dr Kass is a Naturopathic Physician, so please make sure that these services are covered when performed by a Naturopathic Physician.
INSURANCE SPECIFIC NOTES
As of Jan 1, 2018, I am out of network with Cigna, as they do not cover the frenotomy procedures. Cigna patients can pay for the visits at the time of service.
CHPW (Community Health Plan of Washington) requires a referral from the patient’s primary care provider. This referral must be faxed by your baby’s PCP to CHPW (fax number: 206-652-7076). When CHPW approves it, they will fax an approval back to your PCP. Your PCP should fax that approval to us (fax number: 855-897-3364). Once we receive the approval, you can schedule the appointment.
UnitedHealthcare Medicaid/AppleHealth plans -- check the upper right corner of the card. If there is something like NPN or HMSO, or you know that your benefits are administered by a capitated/managed plan, please call them and confirm they will cover Dr Kass. In general, they will not.
Late Cancellation Policy
Please do not schedule appointments you do not intend to keep. When you cancel with less than 24 hours notice, or don’t show up for your appointment, you are denying another family the opportunity to be seen and will be billed $100 for a no-show. This cost is not covered by insurance.
Before, during and after...
BEFORE YOUR VISIT
A few days before your visit, you’ll get a text message and/or email to confirm the appointment and begin registration, which covers insurance, demographics, and signatures. Soon we hope to have medical history done through this process as well, but right now we’re doing that on paper when you arrive for your appointment.
Confirm insurance benefits. If we bill your insurance, but your insurance does not cover the procedure, or does not cover Dr Kass, you may be billed the entire cost of the visit directly. Time of service pricing is only available if you pay at the time of service.
Collect information about your baby’s weights, including birth weight, lowest weight, and any recent weights, along with the dates they were weighed. This information helps us understand how your baby has been growing.
Vitamin K is very important for blood clotting. We strongly recommend baby have received vitamin K prior to the visit.
THE DAY OF THE VISIT
Avoid white or precious clothes for either baby or the breastfeeding parent
Arrive 15 minutes before your appointment time to fill out any remaining forms and have your insurance added to the system.
Baby must eat after the procedure, so please bring whatever your baby currently uses to eat.
PLEASE BRING TO THE VISIT
if you are breastfeeding, please bring whatever you use for breastfeeding, including nipple shields, SNS, etc. If breastfeeding is very challenging or difficult to do while baby is upset, and you typically use a bottle in that situation, please bring bottles and milk or formula as well.
if you are bottle feeding, please bring bottles of expressed milk or formula.
your baby’s weights, including birth weight, lowest weight, and any recent weights, along with the dates they were weighed.
a pacifier — Soothie or Gumdrop type for post-procedure exercises
infant Tylenol (acetaminophen)