Primary Care Coding Alert

Question: I am getting denials when I bill V15.82 with 94406. What would be the more appropriate code? California Subscriber Answer: Smoking cessation is valid only if there is a proven medical necessity for it which includes people who are diagnosed with a smoking-related illness or are taking medicine that may be affected by tobacco. Using V15.82 (History of tobacco use) will not point out the medical necessity for smoking cessation. Further, ICD-9-CM indicates that V15.82 is considered a secondary diagnosis, so you cannot rely on it as a primary diagnosis in any case. Therefore, in this scenario, you should specify what specific disease was present in the patient that warranted the program. For example, a patient enrolled in a smoking cessation program could be reported as follows: • 491.0 -Simple chronic bronchitis (which includes smokers' cough) • 305.1 -Tobacco use disorder • 99406 -Smoking and tobacco use cessation counseling visit; intermediate, greater [...]