Cardiology Coding Alert

Question:  How should I code the following case for an established patient? More than 10 minutes discussing importance of quitting smoking Comprehensive history, comprehensive exam, moderate MDM ECG and interpretation Occasional palpitations, benign HTN, tobacco use, atypical chest pain, COPD. Florida Subscriber Answer: Your case involves tobacco cessation counseling, an established patient office visit, and electrocardiogram (ECG) for a patient with multiple diagnoses. Assuming there's proper documentation, you may report the ECG and tobacco cessation counseling in addition to the E/M service. Smoking cessation: The physician documents more than 10 minutes of counseling, so you should report 99407 (Smoking and tobacco use cessation counseling visit; intensive, greater than 10 minutes). Be sure the session meets payer frequency requirements. Also, remember Medicare has distinct codes if the patient is asymptomatic for tobacco-related disease (G0436-G0437, Smoking and tobacco cessation counseling visit for the asymptomatic patient ...). This patient has COPD so the [...]