Pulmonology Coding Alert

Question: Which patients qualify for face to face smoking cessation counseling services? Does Medicare pay for only those patients who are symptomatic?

Illinois Subscriber

Answer: According to CMS manual, currently Medicare covers smoking cessation counseling for both outpatients and hospital side patients, given that:

• The client uses tobacco products, whether or not they depict signs and symptoms of tobacco related disease
• The client is alert and oriented at the time of counseling.
• A qualified physician or Medicare approved practitioner administers the counselling session.

In case you are wondering which ICD-10-CM code to append for the smoking cessation counseling of the apparently healthy, you may use Z87.891 (Personal history of nicotine dependence).

For further explanation, refer article “Tread Cautiously with the New LDCT Lung Cancer Screening SDM Reporting” in the Pulmonology Coding Alert, Volume 17, Number 6.