Cardiology Coding Alert

Question: Does the cardiologist need to document a plan and referral to a treatment center to support smoking cessation counseling? Utah Subscriber Answer: An action plan and referral are not part of CMSs national requirements for reporting smoking counseling cessation. The Medicare National Coverage Determinations Manual, Section 210.4, and Medicare Claims Processing Manual (MCPM), Chapter 32, Section 12.6 (Post-Payment Review for Smoking and Tobacco-Use Cessation Counseling Services), do not require covered counseling to include a plan for the patient to quit or a referral to a treatment center. Take note: MCPM, Chapter 32, Section 12.6, states that Providers must keep patient record information on file for each Medicare patient for whom a Smoking and Tobacco-Use Cessation Counseling claim is made. These medical records can be used in any post-payment reviews and must include standard information along with sufficient patient histories to allow determination that the steps required in the coverage [...]