smoking cessation PQRS

billybrandle1964

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One of my doctors was wanting to check into billing for smoking cessation. he was thinking we can bill $2-$3 dollars. anyone know if we can bill for this PQRS code? billing G0436 for smoking cessation counseling.
 

txmays

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Tammy Mays, charge entry, Vantage Oncology

This is a good question and one that is answered in this months Healthcare Business Monthly. The patient criteria, per CMS, defines a patient that needs this counseling as "who use tobacco and have been diagnosed with a recognized tobacco-related disease or who exhibit symptoms consistent with tobacco related disease".
On pages 22-23, it is outlined for us to make sure the patients carrier will reimburse for this service. Codes 99406 and 99407 are both Smoking Cessation Codes.
They also wisely advise: "The claim and documented encounter should include tobacco use status and confirmed tobacco-related diseases, as appropriate".

Hope this helps!
 
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