Otolaryngology Coding Alert

Question: During a follow-up evaluation and management (E/M) visit for chronic sinusitis and pharyngitis, the otolaryngologist asked if the patient smoked. The patient attested that they didn’t smoke, they vaped. The ENT then performed smoking cessation counseling for eight minutes.

Do smoking cessation counseling CPT^® codes count if the provider counsels the patient to stop vaping?

Pennsylvania Subscriber

Answer: Yes. According to the September 2020 issue of CPT^® Assistant, coders may use smoking cessation counseling codes for vaping cessation counseling. So, you may report smoking cessation counseling codes, such as 99406 (Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes) and 99407 (… intensive, greater than 10 minutes), for counseling related to vaping cessation.

Vape products, or e-cigarettes, contain nicotine, and that is the substance for which the provider is counseling for cessation. Some coders may use 99408-99409 (Alcohol and/or substance (other than tobacco) abuse structured screening (eg, AUDIT, DAST), and brief intervention (SBI) services …) thinking that vaping falls under the “substance other than tobacco,” but that’s incorrect.