Wiki CPT 99406/99407 advice

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jhendrix08

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My provider wants to start billing for smoking cessation so I'm doing some research to be sure we bill correctly. In reading some posts in the forum, it looks like several people have commented that they have received denials from Medicare for smoking cessation counseling and that it was likely due to the Dx codes, specifically the F17.20 - F17.299 codes. Does anyone have experience with this? I read today that you can also bill with T65.211A-T65.294A. Has anyone had success with these codes? Also, I read that the G codes for Medicare were deleted several years ago and were replaced with 99406-99407; same codes as commercial payers. Do I have that right?

Last question: My provider wants to include a "smoking cessation video" that the patient watches at the end of their visit. I'm wondering if any of you that bill for this have used this type of education material included in the counseling.

Thanks much for any feeback!! Your time is appreciated!
 
We don't bill often for smoking cessation, but I've had good success from Medicare by billing 99406 to dx code Z71.6, with a mod -25 on the preceding E/M code

I've never had to bill a 99407, but I imagine there's nothing different compared to a 99406
 
Education material is not billable in that sense, unless the provider specifically follows along and actually counsels the patient on it.
 
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