Pulmonology Coding Alert

Question: The pulmonologist-referred preventive care physician spent 10 minutes counseling a 45-year-old asthmatic patient who dips tobacco. She advised the patient on the risks involved in using dip and motivates the patient to stop the behavior. How should I report the tobacco use cessation counseling when the visit was for preventive medicine?

New Mexico Subscriber

Answer: You can code the tobacco use cessation counseling and office visit service separately. For the 10 minutes of tobacco cessation counseling, use 99406 (Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes) and 305.1 (Tobacco use disorder). Also, report 99213--25 linked to 493.90.

Warning: Pulmonologists do not report preventive care. In August, the Department of Health and Human Services announced that Medicare would cover tobacco cessation counseling, which it only did in the past if a recipient had already been diagnosed with a tobacco-related disease or showed symptoms of such a disease.