Items to include in the document may comprise the following components:
When services are delivered, patients must be competent and alert, according to the Centers for Medicare and Medicaid Services (CMS) decision memo on smoking and tobacco use cessation counseling. Despite the fact that this service is reportable at the same time as an evaluation and management (E&M) service, the E&M service must be unique and independent from the other services.
In-person therapy for smoking and tobacco use cessation that takes between 3 and 10 minutes is classified as intermediate (99406). 99407-Intense smoking and tobacco use cessation therapy session lasting more than 10 minutes (99407-Intensive smoking and tobacco use cessation counseling visit lasting more than 10 minutes)
There are a variety of strategies available to assist people in quitting smoking. Although different smoking cessation aids, such as prescription medicine, nicotine replacement therapy (NRT), and e-cigarettes, will be more effective for different people, we know that those who get behavioural assistance are more likely to be successful in their efforts to quit smoking.
Uncomplicated nicotine dependency in the form of cigarettes (F17,210).
CPT codes for smoking cessation are listed below.
|Code||Description||Total National facility RVUs|
|99406||Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes||0.35|
|99407||greater than 10 minutes||0.74|
Tips for Documentation: When recording present and historical history of nicotine use/dependence, be as precise as possible. For example, rather of just stating ″quit smoking cigarettes in 2014″ or ″quit cigars at the age of 42,″ record ″quit smoking cigarettes in 2014″ or ″quit cigars at the age of 42.″
With regard to the fifth A, ″Assist,″ the most effective evidence-based strategy is to combine counseling with FDA-approved smoking cessation medications (smoking cessation medications), such as nicotine replacement therapy (gum, lozenges, patch, nasal spray, or oral inhaler), varenicline, and naltrexone (naltrexone is a prescription medication).
A patient who has been tested for tobacco use AND who has received tobacco cessation assistance (counseling, medication, or both) if they are found to be a tobacco user (CPT II 4004F) OR. Patient was screened for tobacco use and was found to be a non-user of tobacco products. CPT II 1036F: Current non-user of tobacco products.
Patient has been screened for tobacco use and has been identified as a non-user of tobacco. Met performance criteria: CPT II 1036F: current non-user of tobacco. OR. For medical reasons, no tobacco screening was performed, and no tobacco cessation intervention was provided.
The following codes may be used by physicians or other certified health professionals who provide E/M services and are required to submit a report: 99441: E/M service over the phone; 5-10 minutes of medical conversation is provided. 99442: E/M service over the phone; 11-20 minutes of medical consultation time.
CPT® Code 1034F – Patient History – Codify by the American Academy of Pediatrics.
CPT® Code 99396 – Established Patient Preventive Medicine Services – Codified by the American Academy of Preventive Medicine. CPT Evaluation and Management Services is a division of CPT. Preventive medicine services are provided.
1. The CPT codes G0436 (Smoking and tobacco cessation counseling visit for the asymptomatic patient; intermediate, greater than 3 minutes, up to 10 minutes) and G0437 (Smoking and tobacco cessation counseling visit for the asymptomatic patient; intensive, greater than 3 minutes, up to 10 minutes) will no longer be considered valid for Medicare purposes.
99406 and 99407 are refunded if they are invoiced separately. Whenever this code is billed in conjunction with another evaluation and management code, the codes will be combined into a single cost. Providers should include a ″25″ modifier to the end of the 99406 or 99407 codes in order to get reimbursement in this situation.
Varenicline (commonly known as Chantix) is a prescription medication that was created to assist smokers in quitting. It works by interfering with the nicotine receptors in the brain, which are responsible for nicotine addiction. This implies that it has two effects: Cigarette smoking is less pleasurable when this is the case.