Cardiology Coding Alert

Question: Sometimes we fret over the difficulty of getting paid for the numerous nonphysician counseling services our practice provides. I heard we'll have new smoking-cessation codes and won't have to report 99401-99412 or 96150-96155. Is that true?

Florida Subscriber

Answer: Yes. As of Jan. 1, you'll use 99406 (Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes) and 99407 (Smoking and tobacco use cessation counseling visit; intensive, greater than 10 minutes) when your cardiologist provides smoking cessation counseling. Notice: The new codes are time-based.

You'll use these two new codes rather than the generic counseling and/or risk factor reduction intervention codes (99401-99412) for patients with no symptoms or established illness, or health and behavior assessment/intervention codes (96150-96155) for patients with disease-related problems. Also, you should use the new codes rather than Medicare's G0375 (Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes) and G0376 (... intensive, greater than 10 minutes), which the AMA converted into the new codes.

Example: A 21-year-old with worsening asthma visits the nurse for smoking-cessation assessment and returns in one month for intervention, beginning a cessation program. In 2008, if a payer doesn't cover 96150 (Health and behavior assessment [e.g., health-focused clinical interview, behavioral observations, psychophysiological monitoring, health-oriented questionnaires], each 15 minutes face-to-face with the patient; initial assessment) and 96152 (Health and behavior intervention, each 15 minutes, face-to-face; individual) for this encounter, you could use a smoking-cessation counseling code based on time.

-- You Be the Coder and Reader Questions were prepared with the assistance of Jim Collins, ACS-CA, CHCC, CPC, CEO of the Cardiology Coalition and compliance manager for several cardiology groups around the country; and reviewed by Jerome Williams Jr., MD, FACC, a cardiologist with Mid Carolina Cardiology in N.C.