READER QUESTIONS:
Consider Payer Preference for Cessation Counseling
Published on Tue Apr 28, 2009
Question: My pulmonologist wants me to make sure we are capturing the time he spends on individual smoking cessation counseling, but I have received a few denials for the HCPCS code (S9075) I am using. Would I have better luck using the CPT codes (99401-99404)? Montana Subscriber Answer: Since no global rules exist for reporting smoking cessation, achieving reimbursement for these services can be tricky. Further complicating the matter is the fact that many private payers prefer standard CPT codes rather than HCPCS codes, while some still accept the latter. If a patient does not have a smoking-related illness or disease that made him a candidate for a cessation program, consider billing 99401-99404 (Preventive medicine counseling and/or risk factor reduction intervention[s] ...). If the patient is a Medicare beneficiary and has a smoking-related illness, disease, or symptom, you can capture various counseling lengths in light of the established condition or [...]
