99407 Intensive Smoking and tobacco use cessation counseling visit is greater than 10 minutes ICD-10 CM Diagnosis Code Description F17.200 Nicotine dependence, unspecified, uncomplicated
Oct 01, 2021 · Tobacco abuse counseling. Z71.6 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM Z71.6 became effective on October 1, 2021. This is the American ICD-10-CM version of Z71.6 - other international versions of ICD-10 Z71.6 may differ.
Showing 1-25: ICD-10-CM Diagnosis Code Z71.6 [convert to ICD-9-CM] Tobacco abuse counseling. Smoking cessation counseling; Smoking cessation counseling done; code for nicotine dependence (F17.-) ICD-10-CM Diagnosis Code Z71.6. Tobacco abuse counseling.
Showing 1-25: ICD-10-CM Diagnosis Code Z71.6 [convert to ICD-9-CM] Tobacco abuse counseling. Smoking cessation counseling; Smoking cessation counseling done; code for nicotine dependence (F17.-) ICD-10-CM Diagnosis Code Z71.6. Tobacco abuse counseling.
99407 Intensive Smoking and tobacco use cessation counseling visit is greater than 10 minutes ICD-10 CM Diagnosis Code Description F17.200 Nicotine dependence, unspecified, uncomplicated
The CPT codes for billing for smoking cessation include: 99406 – Smoking and tobacco use cessation counseling visit; intermediate, greater than three minutes, up to 10 minutes. 99407 – Smoking and tobacco use cessation counseling visit; intensive, greater than 10 minutes.
This means that Medicare and commercial insurance carriers must provide coverage for smoking cessation counseling and interventions. These services include: Tobacco use screening for all adults and adolescents. Tobacco cessation counseling for adults and adolescents who use tobacco, and expanded counseling for pregnant women.
In 2010, the American Cancer Society reported that 7 out of 10 smokers who desired to quit smoking were successful! It is possible to quit smoking with proper help from a physician who takes the time to counsel each patient on the benefits of quitting smoking, along with appropriate prescriptions, if necessary.
The 2019 CMS guidelines state that Medicare covers two cessation attempts per 12-month period. Each attempt includes a maximum of up to four intermediate (99406) or intensive (99407) counseling sessions, with a total Medicare benefit of eight sessions per year. This is not per physician, or per attempt, but per patient.
Terry Fletcher, BS, CPC, CCC, CEMC, CCS, CCS-P, CMC, CMSCS, CMCS, ACS-CA, SCP-CA, QMGC, QMCRC, is a healthcare coding consultant, educator, and auditor with more than 30 years of experience. Terry is a past member of the national advisory board for AAPC, past chair of the AAPCCA, and an AAPC national and regional conference educator. Terry is the author of several coding and reimbursement publications, as well as a practice auditor for multiple specialty practices around the country. Her coding and reimbursement specialties include cardiology, peripheral cardiology, gastroenterology, E&M auditing, orthopedics, general surgery, neurology, interventional radiology, and telehealth/telemedicine. Terry is a member of the ICD10monitor editorial board and a popular panelist on Talk Ten Tuesdays.
Medicare Part B (provider component) covers two levels of tobacco cessation counseling for symptomatic and asymptomatic patients: intermediate (great than 3 minutes but no more than 10 minutes) and intensive (greater than 10 minutes).
ICD-10 codes are used by physicians and other health care providers to classify and code all diagnoses, symptoms, and procedures in U.S. health care settings on claims for services provided. These codes are used by payers to determine coverage, not the amount that will be paid. Separately, payers have schedules which match the codes to the specific provider’s negotiated rate.
Tobacco use status is now embedded in most of the major electronic health records and evidence-based tobacco cessation counseling and pharmacotherapy covered by Medicare, Medicaid and most private health plans. Despite improved documentation and coverage, few providers bill for cessation services.
The Affordable Care Act (ACA) expanded tobacco cessation coverage for the Medicaid population, but gives states the ability to distinguish between the standard Medicaid and Medicaid expansion populations in terms of cessation coverage.
Medicaid managed care organizations (MCOs) are required to provide at least a comparable level of benefits to the fee-for-service option (77 percent of state Medicaid recipients are currently served by Medicaid MCOs).
It provides a uniform mechanism for describing services and procedures among providers, payers, and patients, as well as coders and analytical entities. For this document, CPT establishes what services or procedures have been provided and the basis for payment by payers.
Similar to the CPT code set, HCPCS is a standardized coding set used by the Centers for Medicare and Medicaid Services, as well as other payers. Like CPT, it includes three levels or categories of codes: