Ob-Gyn 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 (... intensive, greater than 10 minutes) when your ob-gyn 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.

Bonus: You also have two new codes for alcohol and/or substance abuse:

Caution: You should only report these two new codes when a provider with additional training in the area of alcohol and/or substance abuse performs them.