Wiki smoking cessation -component of basic procedure

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veeramani14

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Hi all,

Is there any guidelines for Smoking cessation and office visit billing in same day?

I billed 99214 and 99406 to medicare, they paid only office visit and denied the 99214 as component of basic procedure.

what is the way to get payment for 99214. can anyone help me out?
 
Smoking Cessation

Good morning - be sure to append Mod-25 to the 99214. I am wondering if the 1st Dx to the 99214 is 305.1? Was the patient seen for other problems and the Smoking Cessation Counseling was performed in addition to? 99406 can be billed on the same day as an E/M service but remember it is a time based code and the documentation should reflect that. Good luck! :)
 
Smoking Cessation

Add a 25 modifier to the E/M visit. In North Carolina (Palmetto GBA) will reimburse with 25 modifier on E/M and will reimburse HCPCS cod G0436. MCD and Commercial insurance will reimburse with the 99406 along with 25 modifier on E/M code. Don't forget to use 305.1 diagnosis code as well.
 
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