• Preventive medicine services (office visit services) represented by codes 99381-99387, 99391-99397, 99401- 99404, and 99406-99412 are distinct from problem-oriented evaluation and management office visit codes and are inherently preventive.
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.
99408, 99409, G0396, G0397,G0442, G0443 Allowed with any diagnosis Anemia, Iron Deficiency Anemia Screening: Children age 12 months 85013, 85014, 85018, 85025, 85027, 85041, G0306, G0307 Select Designated Wellness Code from Code Group 1 Bacteriuria Screening: Pregnant women at 12-16 weeks gestation or at the first prenatal visit, if later
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 sessions per year.
F17. 211 Nicotine dependence, cigarettes, in remission.
These are in addition to the two CPT codes 99406 and 99407 that currently are used for tobacco cessation counseling for symptomatic individuals. Medicare will waive the deductible and coinsurance/copayment for counseling and billing with these two new G codes on or after January 1, 2011.
Magnolia Health (MH) indicates that 99406 and 99407 are reimbursed with no modifier or diagnosis limitations. The codes are payable on the physician side, but are not covered for outpatient facility claims.
Medicare and most private insurers pay for physicians, NPs and PAs to counsel patients about stopping tobacco use.
99406 – Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes.
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 ...
HCPCS/CPT Code Type of Counseling Description 99406. Intermediate. Smoking and tobacco use. cessation counseling visit is. greater than three minutes, but.
In addition, the following services can also now be billed when using audio only: Advance Care Planning (CPT 99497, 99498) Annual Wellness Visits (HCPCS G0438, G0439) Smoking Cessation Services (CPT 99406, 99407)
If you check the CCI edits, you'll see that 99406 is a Column 2 code when billed with 90471. You need either a -59 modifer OR one of the X{EPSU} modifiers on 99406 if it is supported by the documentation as a separate service.
Nicotine dependence, unspecified, uncomplicated F17. 200 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 F17. 200 became effective on October 1, 2021.
Description of CPT code 99406 & 99407 CPT code 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.
• 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
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 ...
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.
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
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.
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 ...
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.