Wiki Smoking cessation treatment-HELP!!!!!!!!!!!!!!!!!!!!!!!!!

[Elizabethchris]

Hi all! Does anyone know if CPT 99407-Smoking and tobacco use cessation counseling visit can be billed by a Psychologist? The code psychologists used to report was S9075, but it has now expired and according to Optum encoder, the crosswalk is now 99407. Unfortunately, 99407 falls under the E&M section and psychologists can't report E&M's. Is there an alternative code, or is it okay to report 99407 since S9075 is crosswalking to that code?

S9075 Smoking cessation treatment
99407 Smoking and tobacco use cessation counseling visit; intensive, greater than 10 minutes

 

[Elizabethchris]

Hello

Yes your psychologist can bill CPT codes of the S code or CPT 99407 (used by commercial payers only) for smoking cessation. The catch is he or she must put the minutes in the documentation such as" discussed with patient for 2 to 10 minutes on hazards of smoking". Also this can be an addition service during an office visit. So the provider treats patient on another definitive diagnosis code plus their smoking problem at same date and time. Bill the eval management code of let us say 99214, add modifier 25, then the smoking cessation cpt 99407 on 2nd line of claim. The provider should add the dx code of F17.200 (check out those block of dx codes for more details in smoking counseling). Payers do have regulations on using this CPT code of 99407 smoking cessation such as not more than certain amount of times per year. You need to check this out per payer/insurance company.

Also if the patient is currently smoking it can be listed in their social history on the medical documentation for the day by the provider who can document or state the patient has current or past history of smoking. Once this is done the diagnosis code related to smoking notations can be placed on claim last place of Z72 or Z87. Smoking is a hazard for heart conditions and respiratory problems which you can list the Z72 or Z87 dx code in last place on the insurance claim. And claim sequencing is vital to understand to get proper payment too.

Have a great day!

T Thivierge, BHS CBCS CPC

Hi! Thanks so much for responding! Unfortunately, the "S" code has expired so the Psychologists are a little hesitant to report 99407 as it's listed under the E&M section of CPT and Psychologists cannot report any E&M codes. Would you happen to have a link to a web page that states Psychologists can report 99407 code?

Thanks again for your help!