Pulmonology Coding Alert

Question: Since the start of the new year, several of our patients are seeking smoking cessation counseling, but they live in rural areas and have been unable to travel to our practice. The pulmonologist has performed smoking cessation counseling with the patients via telephone calls.

Is there a modifier we should append to the smoking cessation codes?

West Virginia Subscriber

Answer: Yes, you’ll append modifier 93 (Synchronous telemedicine service rendered via telephone or other real-time interactive audio-only telecommunications system) to the appropriate smoking cessation counseling code to indicate the provider performed the service via a telephone call.

The audio-only telemedicine modifier was added to the CPT® code set Jan. 1, 2022, and the CPT^® Editorial Panel approved adding Appendix T to the CPT^® code set at the February 2022 meeting. Appendix T includes guidelines for using modifier 93 as well as a list of approved codes, such as:

• 99406 (Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes)
• 99407 (… intensive, greater than 10 minutes)

The CPT^® code set includes several codes that are designated for audio-only services, but providers can provide other services through audio-only technology. For that reason, the CPT^® Editorial Panel approved modifier 93’s addition to the code set. According to the August 2022 issue of CPT^® Assistant, “Rather than create all new codes to identify these services, modifier 93 was created to append to the appropriate code(s) to report these services.”

In summary, depending on how much time was spent providing smoking cessation counseling over a telephone call, you’ll assign 99406-93 or 99407-93 to report the service.