Optum360 coding books logo
    Contact Us   (7 a.m.–7 p.m. CST)
  Home > Coding Central Articles > Coding Central Articles  
Coding Central
Coding Central Home
Inside Track to ICD-10
Coding Central Articles
Code This!
Case Studies
Chargemaster Corner

Articles for:
March 27, 2018

Spring OPPS Update Released

The Centers for Medicare and Medicaid Services (CMS) summarized the spring update to the outpatie... Learn More

Therapy Caps Repealed and Payment for Therapy Assistant Services Lowered

Medicare payment caps on outpatient therapy were permanently repealed effective January 1, 2018. ... Learn More

OIG Update Work Plan, Studies Cardiac Device Credits

In March, the Office of Inspector General (OIG) posted several updates to its existing Work Plan,... Learn More

View Article Archive

To subscribe, paste this link into your preferred feedreader, or click on one of the buttons below:

Medical Coding News Archives

Remember to Bill Smoking and Tobacco Cessation Counseling

February 12, 2008:
By correctly billing for a service many providers are already performing, practices could see increased revenues. Many providers are not aware that Medicare covers eight smoking and tobacco use cessation counseling sessions in a year—and that another eight sessions are paid for during a second or subsequent year once 11 full months have passed since the first covered visit.

Prior to January 1, 2008, providers should have billed this service using codes G0375 and G0376. However, after January 1 CPT® codes 99406 and 99407 should be used.

99406 Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes

99407 intensive, greater than 10 minutes

Correct code assignment depends on time. Documentation should contain information regarding the specific counseling methods used. Remember, any counseling that is 3 minutes or less is considered incidental to the evaluation and management (E/M) service and therefore not separately reportable. For these reasons, it is advisable to document the total time spent counseling the patient.

More than likely, providers are already performing this service. By knowing what documentation is necessary to support code assignment, your practice may be able to begin to bill for this counseling without any appreciable increase in work. The Medicare national average payment is $12.19 and $23.99, respectively, and could add a significant influx to cash flow. If each is billed just once per day, the average additional revenue a practice could see could be more than $8,500 ($36.18 per day multiplied by 240 days).

Deborah C. Hall
Clinical/Technical Editor

CPT is a registered trademark of the American Medical Association.


Sign in to
Your Account
Forgot your username?
Forgot your password?
Don't have an account?
It's easy to create one.

Promo code

Have a promotional source code? Enter it here:

What is this?