Bill for Smoking Cessation
By Jackie Stack, CPC, CPC-I, CEMC, CFPC, CIMC, CPEDC
The smoking cessation codes have sparked a lot of attention lately. Yes, you really can bill for these services, but not every payer will reimburse you.
Let’s look at the codes and descriptor requirements. Note that if you counsel the patient for fewer than three minutes, you would not report these codes. Be sure that the time spent counseling is specified in the medical record.
99406 – Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes
99407 – intensive, greater than10 minutes
HCPCS Level II Codes
G0436 – Smoking and tobacco cessation counseling visit for the asymptomatic patient; intermediate, greater than 3 minutes, up to 10 minutes
G0437– intensive, greater than10 minutes
Payers who do not reimburse for these services may, nonetheless, apply the charges toward any unmet patient deductable. Other payers may bundle the services to any other E/M service on the same day. Check with your insurance plans for details, so that you are able to inform patients whether the service will be covered. Note that insurers may offer different plans with varying coverage. For example, Blue Cross/Blue Shield covers smoking cessation on some of their plans, but not on others.