Primary Care Coding Alert

Question: A 60-year-old established Medicare patient with a confirmed diagnosis of vanishing lung (emphysema) reports to the FP for a medication check and blood work; the patient is a moderate smoker. During the medication check and blood work, which took about 5 minutes, the patient tells the practice's NPP "I think I'm ready to quit smoking; can you help?" The NPP spends the next 7 minutes providing smoking cessation counseling for the patient. Can I report a cessation code and an E/M?Illinois SubscriberAnswer: Provided the patient meets Medicare's requirements for cessation counseling, you can report the following: 99211 (Office or other outpatient visit for the evaluation and management of an established patient, that may not require the presence of a physician. Usually, the presenting problem[s] are minimal. Typically, 5 minutes or less are spent performing or supervising these services. ) for the E/M492.0 (Emphysema; emphysematous bleb) appended to 99211 to [...]