Wiki Smoking cessation

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kamkorey

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I have questions regarding charging for smoking cessation counseling, CPT codes 99406 and 99407, specifically. Can anyone shed some light on what documentation is needed in order to charge these codes? Also, when billing, do we append a 59 modifier to depict a separate service if combined with an office visit and also a 25 modifier on the office visit? When completing our Medicare AWV's, we are rarely reimbursed for this. We also use CPT code 4004F on the AWV's if the patient is a smoker and counseling is done. This is a $0 charge, but, we use it for tracking screenings. Do you all use this code?
 
kamkorey said:
I have questions regarding charging for smoking cessation counseling, CPT codes 99406 and 99407, specifically. Can anyone shed some light on what documentation is needed in order to charge these codes? Also, when billing, do we append a 59 modifier to depict a separate service if combined with an office visit and also a 25 modifier on the office visit? When completing our Medicare AWV's, we are rarely reimbursed for this. We also use CPT code 4004F on the AWV's if the patient is a smoker and counseling is done. This is a $0 charge, but, we use it for tracking screenings. Do you all use this code?
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We created a template for providers to use, here is an example:
  • Make a Quit Plan: Encouraged patient to build a quit plan, or find a quit program that works for them. and Encouraged the patient to use QuitGuide app or a quitline, 1-800-QUIT-NOW.
  • Stay Busy: Encouraged patient to stay busy to help keep their mind off smoking and distract from cravings., Encouraged deep breathing exercises., Encouraged patient to chew gum or hard candy. and encouraged the patient to start an exercise program.
  • Avoid Smoking Triggers: Encouraged patient to change routine to avoid the things they might associate with smoking., Instructed patient to get plenty of rest and eat healthy. Being tired can trigger you to smoke. and encouraged the patient to throw away cigarettes, lighters, and ashtrays.
  • Stay Positive: Encouraged the patient to remind themselves to be smoke-free for 24 hours.
  • Ask for Help: Tell your family and friends your quit day, and ask for support. and Let your family know how they can support you.
  • Time Spent Counseling: 3 minutes
If doing with E/M you only need a 25 modifier on E/M. We have also charged 99406/99407 with AWVs. We use modifier 25 on AWV. You would only need modifier 59 on 99406/99407 if other procedures or assessments were completed.
 
KamKorey
Also when doing smoking cessation provider needs to list in med record/documentation minutes discussion smoking cessation 5 -10 minute ,Etc . Also dx F17.200 is better dx than Z72.0 as last dx code =both current smoking. If provider states recurrent use dx related to F17.211 vs F17.213 withdrawal . Dx F18 block defines inhalant abuse.
I hope this data helps
Lady T
 
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