Wiki E/M code, smoking cessation dilemma - HELP

[kakirchman]

I code for a family practice clinic. One of my doctors just got his certification for addiction billing. He saw a patient for an acute problem, performed an annual, and counseling for smoking. This patient has BCBS, so no MC codes.

99214
99396
99406

99396 and 99406 are both screening codes, neither is a 'procedure', so 59 is not applicable. I know that 25 needs to be appended to 99214. How can I bill the other 2 as well without it bundling them together? Should I have him add the counseling time into the 99214 instead? Any help would be appreciated!

Thanks!

 

[sWold1437]

One concern I have is the level of the E&M (99214), along with the annual exam - make sure the level is justified. You are correct that modifier 25 would go on the 99214 (or whatever it is determined to be). To bill for the smoking cessation counseling, which is a time-based code, the provider must document the time spent in counseling. If not, I would consider rolling it up into the physician exam. Hope this helps,