G9779 Breastfeeding Status | HCPCS Reimbursement | OpenPayer

Summary & Overview

HCPCS G9779: Breastfeeding Status During Performance Period

HCPCS Level II code G9779 captures whether a patient was breastfeeding at any time during the performance period. This non-procedural, documentation-focused code supports population health reporting and quality measurement related to maternal and infant health. Nationally, documentation of breastfeeding status informs maternal-newborn care pathways, lactation support services, and performance metrics used by payers and health systems.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the code's clinical intent, the typical service settings where it is captured, and the role the code plays in quality reporting and care coordination. The publication also summarizes payer coverage considerations and common billing modifiers associated with HCPCS Level II reporting when available.

The content outlines benchmarks and reporting implications rather than clinical guidance. It provides context for coding teams, quality leads, and billing professionals seeking clarity on how G9779 is used in documentation and reporting workflows, and it highlights where supplemental data is or is not available for deeper reimbursement or policy interpretation.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareG9779HCPCS Level IIbreastfeedingmaternal healthquality reportingpostnatal carelactation statusoutpatientdocumentation

Billing Code Overview

HCPCS Level II code G9779 indicates patients who are breastfeeding at any time during the performance period. This code is used to document the presence of breastfeeding among patients during the period in which services are measured.

Service type: Maternal/postnatal care documentation and screening
Typical site of service: Ambulatory clinics, obstetrics and gynecology practices, pediatric clinics, and other outpatient settings where maternal or lactation status is assessed

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A typical patient is a postpartum individual who is actively breastfeeding during the program measurement period for quality reporting. The patient presents for routine postpartum follow-up clinic or a well-child visit with lactation support integrated into maternal care. Clinical workflow: registration records breastfeeding status; clinician documents breastfeeding at any point during the performance period in the medical record (example: patient reports exclusive breastfeeding for first 8 weeks and partial breastfeeding through 3 months). Coding staff capture billing code G9779 to indicate the patient was breastfeeding during the performance period for quality measurement. Encounters commonly occur in outpatient obstetrics/gynecology clinics, family medicine, pediatric clinics (maternal component documented), or dedicated lactation clinics. Typical scenario: a 28-year-old postpartum patient attends a 6-week postpartum visit, reports continued breastfeeding, receives lactation counseling and breast exam as indicated, and the clinician documents breastfeeding status in the maternal postpartum record, supporting assignment of G9779 for reporting purposes.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when services provided during the encounter required substantially greater effort than typical (rare for this quality reporting code; applied to an associated service when appropriate).

HCPCS G0569: Subsequent Psychiatric Collaborative Care Management

HCPCS-G9245-ANTIRETROVIRAL-THERAPY-PRESCRIBED

HCPCS G9245: Antiretroviral Therapy Prescribed

HCPCS-G0413-PERCUTANEOUS-POSTERIOR-PELVIC-FIXATION

HCPCS G0413: Percutaneous Fixation of Posterior Pelvic Fracture

HCPCS-G8551-HEART-FAILURE-QUALITY-MEASURES-COMPLETE

HCPCS G8551: Heart Failure Quality Measures Completed

HCPCS-G0378-HOSPITAL-OBSERVATION-SERVICE-HOURLY

HCPCS G0378: Hospital Observation Service, Per Hour

HCPCS-G0053-ADVANCING-RHEUMATOLOGY-PATIENT-CARE-MIPS-VALUE-PATHWAYS

HCPCS G0053: Advancing Rheumatology Patient Care MIPS Value Pathways

HCPCS-G8728-FASTING-LIPID-PROFILE-NOT-PERFORMED-NO-REASON

HCPCS G8728: Fasting Lipid Profile Not Performed, Reason Not Given

HCPCS-G9226-FOOT-EXAMINATION-COMPREHENSIVE-FOOT-SCREENING

HCPCS G9226: Comprehensive Foot Examination, Sensory and Vascular Assessment

HCPCS-G0085-EXTENSIVE-CARE-MANAGEMENT-HOME-VISIT-75MIN

HCPCS G0085: Extensive Care Management Home Visit, 75 Minutes

HCPCS-G9158-MOTOR-SPEECH-DISCHARGE-FUNCTIONAL-STATUS

HCPCS G9158: Motor Speech Functional Limitation, Discharge Status

Showing 1–10 of 1996

Taxonomy Code	Specialty	Notes
`207Q00000X`	Obstetrics & Gynecology	Primary specialty managing postpartum visits and breastfeeding documentation.
`207RF0000X`	Family Medicine	Provides postpartum care and lactation counseling in primary care settings.
`208000000X`	Pediatrics	Documents maternal breastfeeding status during infant visits when maternal status is captured.
`363L00000X`	Lactation Consultant	Provides specialized lactation support and counseling; documents breastfeeding status for quality reporting.
`1835S0002X`	Registered Nurse	Performs lactation education and documents breastfeeding status in the chart.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Z39.2`	Encounter for routine postpartum follow-up	Commonly used when documenting postpartum visits where breastfeeding status is assessed and recorded.
`Z39.80`	Encounter for full-term uncomplicated delivery, unspecified as to episode of care	Relevant when documenting postpartum care and breastfeeding after an uncomplicated delivery.
`O91.11`	Superficial infection of nipple associated with childbirth	Breastfeeding-related condition that may be documented during lactation visits.
`O92.82`	Engorgement of breast associated with childbirth	Directly related to lactation and breastfeeding management.
`O92.81`	Nonpuerperal mastitis and breast abscess	Breast conditions that can affect breastfeeding and are relevant to documentation.
`Z76.89`	Encounter for other specified health reasons	Used when specific breastfeeding counseling or lactation support is provided but not covered by a more specific code.
`Z33.1`	Pregnant state, incidental	Occasionally present in peripartum contexts when breastfeeding status is documented across transitions of care.
`Z64.0`	Problems related to unwanted pregnancy	Included only as a contextual maternal code that may appear in maternal records; breastfeeding documentation remains relevant.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99401`	Preventive medicine counseling and/or risk factor reduction intervention(s) for an individual; approximately 15 minutes	May be used for brief lactation counseling or breastfeeding education during a postpartum visit.
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes	Common E/M code for a routine postpartum visit where breastfeeding status is documented and `G9779` is reported for quality measurement.
`97161`	Physical therapy evaluation, low complexity	Used when a postpartum patient requires pelvic floor or breastfeeding-related physical therapy evaluation; supports documentation of breastfeeding status if relevant.
`99406`	Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes	Often provided during postpartum visits; included as an example of counseling services that may occur alongside breastfeeding support.
`99421`	Online digital evaluation and management service, for an established patient, 5-10 minutes	Telehealth or asynchronous communications used for lactation support and follow-up where breastfeeding status is assessed and documented.

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