Wiki documenting for smoking cessation

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ljohnjan

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I am struggling with the correct documentation for billing the smoking cessation. I have read through the documentation requirements https://www.myoptumhealthphysicalhe...ingCessationCounselingReimbursementPolicy.pdf
The provider I code for continues to document the following
"cessation encouraged. Counseled patient for 3-10 minutes. Patient is not interested in quitting at this time. Will continue to monitor for willingness."
Doesn't the exact time have to be documented and what is actually discussed? Would this qualify to bill for the smoking cessation charge? Everything I am reading tells me that it does not.
Thanks
 
Hi Ljohnjan🚬:)
The documentation by provider must type in how many minutes discuss smoking cessation with the patient who is currently smoking(use dx F17). I believe least amount is 3 minute CPT 99406.Patient has the right to say not stopping smoking cigs,but they were still counseled and can bill it on the claim.The notation by provider looks good, but the preventive CPT is added after either Eval MGnt visit established or new pt visit for NP or MD (CPT 99202-99214) for chornic conditions or new illness add modifier 25 .Then next line on claim the smoking cessation CPT. Whereas beh health visits (90832- ???)_for LCSP or LPC therapist or psychiatrist could list this too after add modifier 25.
I hope this data helps you 🚬:)
Lady T
 
since this is a time based code, documenting that the patient was counseled for 3-10 minutes, would not support the code.
an exact amount of time spent must be documented.

I do agree, that the patient deciding not to take the advice, is not the deciding factor on using these codes.

I would not report smoking cessation with this documentation.
 
ljohnjan said:
I am struggling with the correct documentation for billing the smoking cessation. I have read through the documentation requirements https://www.myoptumhealthphysicalhe...ingCessationCounselingReimbursementPolicy.pdf
The provider I code for continues to document the following
"cessation encouraged. Counseled patient for 3-10 minutes. Patient is not interested in quitting at this time. Will continue to monitor for willingness."
Doesn't the exact time have to be documented and what is actually discussed? Would this qualify to bill for the smoking cessation charge? Everything I am reading tells me that it does not.
Thanks
Click to expand...
Hi there, yes, the note should details, starting with the specific time spent on counseling.

The provider should include information on the patient's current tobacco use and some information on what the counseling entailed. It doesn't have to be a full transcript of the conversation, of course. It could be "Warned the patient about the health risks of smoking, including blah." or "Discussed the health benefits of quitting, such as whatever." or "Showed the patient 27 8x10 glossy photos of diseased lungs and advised them to quit smoking." Another person who looks at the chart - including the provider at a later date - should be able to tell what went on.

As presented the documentation looks like copy/paste.
 
Hi Ljohn,
At my previous coding jobs in a office locations of OP office and a hospital clinic setting would bill for this and get paid using modifier 25 in conjunction with a chronic conditions using Eval. Mgnt codes. However must put minutes in treatment record for just the smoking cessation documentation
Lady T
 
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