icd 10 code for cpt 99406

Full Answer

Is 99406 covered by Medicare?

Smoking Cessation Counseling Codes 99406 and 99407 Reimbursement may be possible if you bill the patient’s insurance company correctly. Medicare covers 2 cessation attempts per 12-month period. Each attempt includes a maximum of up to 4 intermediate (99406) or intensive (99407) counseling sessions, with a total Medicare benefit of 8

What does medical code 99406 mean?

These services are reported using CPT-4 code 99406 (intermediate, E/M counseling service) or code 99407 (intensive, E/M counseling service). The diagnosis code should reflect the condition the patient has that is adversely affected by tobacco use or the condition the patient is being treated for with a therapeutic agent whose metabolism or dosing is affected by tobacco use.

Who can Bill 99408?

substance abuse screening and intervention services. They are CPT code 99408 (Alcohol and/or substance (other than tobacco) abuse structured screening (e.g., AUDIT, DAST), and brief intervention (SBI) services; 15 to 30 minutes); and CPT code 99409 (Alcohol and/or substance (other than tobacco) abuse structured screening

Does 99406 require a modifier?

The CPT codes are listed below for billing for smoking cessation: 99406 – Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes; 99407 – Smoking and tobacco use cessation counseling visit; intensive, greater than 10 minutes; A modifier 25 may be appropriate to append to the primary E/M visit code.

What diagnosis covers 99406?

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

What ICD 10 code to use for smoking cessation?

F17. 201 Nicotine dependence, unspecified, in remission. F17. 210 Nicotine dependence, cigarettes, uncomplicated.

Is 99406 considered an E M code?

Smoking cessation (99406 and 99407) services were developed as E/M services and may be reported with the E/M services 99201-99205 and 99211-99215.

What is the CPT code for smoking cessation?

99406 and 99407In the body of the note, the clinician must document the time of the counseling. The CPT codes for smoking cessation (99406 and 99407) are used for all payers for patients who are symptomatic as a result of smoking.

Do you need modifier 25 with 99406?

If billed alone, 99406 and 99407 are reimbursed. When billed with another evaluation and management code, the codes will bundle to a single fee. To allow payment in this circumstance, providers should append a “25” modifier for 99406 or 99407 codes.

What is the ICD-10 code for F17 210?

F17. 210 Nicotine dependence, cigarettes, uncomplicated - ICD-10-CM Diagnosis Codes.

Does Medicare pay for code 99406?

According to the Medicare Preventive Services guide, Medicare suggests the use of codes 99406 and 99407. A notable change as of October 1, 2016 is that the copayment/coinsurance as well as the deductible for 99406 and 99407 are now waived. The Medicare beneficiary has a zero dollar out-of-pocket liability.

Can 99406 be billed as telehealth?

Medicare patients can access telehealth from their homes (also known as originating site requirements). Previously, patients could only access telehealth from a provider office. Tobacco cessation counseling (CPT codes: 99406 and 99407) can be conducted via audio-only interaction.

What is the ICD-10 code Z87 891?

Personal history of nicotine dependenceICD-10 code Z87. 891 for Personal history of nicotine dependence is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .

What is diagnosis code Z79 899?

ICD-10 Codes for Long-term TherapiesCodeLong-term (current) use ofZ79.84oral hypoglycemic drugsZ79.891opiate analgesicZ79.899other drug therapy21 more rows•Aug 15, 2017

Can 99406 and 99407 be billed together?

CPT® codes for Smoking Cessation 99407 is not an add-on code, and the two codes are never reported together. Report only one of the codes, depending on the time of the counseling.

Can 99406 be billed inpatient?

CPT code 99406, 99407 , C9801, C9802 – Tobacco Use Cessation Counseling. Medicare covers counseling for tobacco cessation for outpatients and for inpatients. Inpatients are covered only if counseling for tobacco use is not the primary reason for the patient's hospital stay. Medicare covers 2 cessation attempts per year ...

How long is a 99406?

• 99406: Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes#N# • 99407: Smoking and tobacco use cessation counseling visit; intensive, greater than 10 minutes

What is the CPT code for smoking cessation?

Effective for services on or after January 1, 2008, you must bill for smoking and tobacco use cessation counseling services with new CPT codes (99406 or 99407) . If you bill using the former HCPCS codes (G0375 and G0376) for services provided after December 31, 2007, your claims will not be paid.

What is the diagnosis code for E/M counseling?

These services are reported using CPT-4 code 99406 (intermediate, E/M counseling service) or code 99407 (intensive, E/M counseling service). The diagnosis code should reflect the condition the patient has that is adversely affected by tobacco use or the condition the patient is being treated for with a therapeutic agent whose metabolism or dosing is affected by tobacco use.

What should a diagnosis code reflect?

Diagnosis codes should reflect ƒ the condition the patient has that is adversely affected by tobacco us, or ƒ the condition the patient is being treated for with a therapeutic agent whose metabolism or dosing is affected by tobacco use. Deductible and coinsurance will apply in a standard medical benefit.

What is the procedure code for smoking cessation?

Procedure code description. • 99406: Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes. Medicare covers counseling for tobacco cessation for outpatients and for inpatients. Inpatients are covered only if counseling for tobacco use is not the primary reason for the patient’s hospital stay.

What is the CPT code for E/M counseling?

CMS does not currently have specific training requirements, but may in the future. The counseling must be provided face-to-face with the patient. These services are reported using CPT-4 code 99406 (intermediate, E/M counseling service) or code 99407 (intensive, E/M counseling service). The diagnosis code should reflect the condition ...

What is C9802?

C9802 – Smoking and tobacco cessation counseling visit for the asymptomatic patient, intensive, greater than 10 minutes

What does CARC 119 mean?

CARC 119: “Benefit maximum for this time period or occurrence has been reached.”

How long is a G0436?

G0436 – Smoking and tobacco cessation counseling visit for the asymptomatic patient; intermediate, greater than 3 minutes, up to 10 minutes Short descriptor: Tobacco-use counsel 3-10 min G0437 – Smoking and tobacco cessation counseling visit for the asymptomatic patient; intensive, greater than 10 minutes Short descriptor: Tobacco-use counsel >10min

What is a 99407?

99407 – Smoking and tobacco-use cessation counseling visit; intensive, greater than 10 minutes

How many minutes is 99407?

99407 – Smoking cessation counseling, greater than 10 minutes Only one procedure code per day may be billed.

What is the CPT code for smoking cessation?

There two CPT Codes 99406 and 99407 that are used for tobacco cessation counseling for symptomatic individuals. • 99406: Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes. • 99407: Smoking and tobacco use cessation counseling visit; intensive, greater than 10 minutes.

When did the G0436 and G0437 waiver start?

Note: Section 4104 of the Affordable Care Act provided for a waiver of the Medicare coinsurance and Part B deductible requirements for counseling to prevent tobacco use services, codes G0436 and G0437, effective on or after January 1, 2011. No other tobacco cessation codes are eligible for waiver of coinsurance/deductible at this time. Prior to January 1, 2011, this service will be subject to the standard Medicare coinsurance and Part B deductible requirements.

What is the diagnosis code for tobacco use disorder?

The diagnosis codes that should be reported for these individuals are ICD-9 codes 305.1, nondependent tobacco use disorder, or V15.82, history of tobacco use.

How long is a G0436?

G0436: Long Descriptor: Smoking and to bacco cessation counseling visit for the asymptomatic patient; intermediate, greater than three minutes, up to 10 minutes; Short Descriptor: Tobacco-use counsel three to 10 minutes.

What is Medicare denied for 99406?

Medicare denied all 99406 ( Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes) codes with my e/m code. I stated the diagnosis code

How many cessation codes does Medicare pay?

Medicare will only pay a total of 8 cessation counseling codes (99406 or 99407) per year; not per provider. If other providers have also billed for cessation your patient could have hit the maximum for the year.