Wiki Critical Care w/Smoking Cessation

[daniel]

Has anyone coded a critical care with a smoking cessation charge?

Can you code critical care with smoking cesssation.

I want to say no, it doesn't seem like these two services would go together.
But the documentation I have meets the criteria for critical care and smoking cessation.

Patient develped hypotension postoperitively, with the possibility of developing sepsis. Patient is being resusitated with IV fluid support.
With SOB with a suspect element of COPD, being institued with brochodilators and O2 supplements.
Smoking cessation provided with more than 10 minitues during this inpatient encounter.


Any input on this.

Thanks
Daniel, CPC

 

[sbicknell]

Smoking and tobacco use cessation counseling visit

The 99406-99407 is defined as a "visit". These codes can be coded with an E&M same day if a distinct and separate service

If the pt is in the middle of Critical Care episode, I just don't see how it would be appropriate to provide counseling. Maybe done later that day? And telling the pt he is "having a heart attack cause he smokes 2 ppd and needs to quit" does support coding 99406-99407

Look in the CPT book in the section right before these codes. There are some specifics as what is expected on these counseling visits. They (I dont have my book in front of me but....) include something like:
assessement of willingness to change behavior
barriers to change
specific suggestions for behavior change
planned follow-up