Wiki TOBACCO CESSATION (cpt 99406)

[Liza5418]

Hi, has anyone out there billed out the smoking cessation code 99406 with modifier 33? If so, what is the appropriate icd 9 code you are using?. There is 305.1 (tobacco dependence) or V15.82 (history of tobacco smoking). The ob/gyn doctors I work for have been using V15.82 even though the patient is still a smoker. To my understanding V15.82 is used for history of (no longer a smoker). Am I correct? Also, can the doctor still counsel a patient on smoking, even though the patient is not longer a smoker?

 

[Pam Warren]

Use codes 99406 (and 99407) when the patient has a condition, such as COPD or asthma, that is exacerbated by tobacco use (or history of tobacco use). CPT describes these codes as behavior change intervention-- performed as part of the treatment or condition (i.e. COPD) related to or potentially exacerbated by the behavior. It does go on to say that these codes can be used for the patient who doesn't yet have a related illness, but I've found that it's better to use G0436 and G0437 for the asymptomatic patient (code 305.1 or V15.82).

Coverage of these codes vary by carrier. Some carriers simply do not cover this service, or they expect you to bundle it into your E&M. Sometimes you have to query the payer to see what procedure codes they prefer.