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March 27, 2018


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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.

 

 
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