Wiki Smoking Cessation with Tobacco Use

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B
Code: z72.0
Tobacco use
Excludes 1: history of tobacco dependence (Z87.891)
nicotine dependence (F17.2-)
tobacco dependence (F17.2-)
tobacco use during pregnancy (O99.33-)
Tobacco use NOS
Parent Code Notes: Z72
Excludes2: problems related to life-management difficulty (Z73.-)
problems related to socioeconomic and psychosocial circumstances (Z55-Z65)

Category Notes
Persons encountering health services in other circumstances (Z69-Z76)

Coding Guidelines
Factors influencing health status and contact with health services (Z00-Z99)
Note: Z codes represent reasons for encounters. A corresponding procedure code must accompany a Z code if a procedure is performed. Categories Z00-Z99 are provided for occasions when circumstances other than a disease, injury or external cause classifiable to categories A00-Y89 are recorded as 'diagnoses' or 'problems'. This can arise in two main ways:
(a) When a person who may or may not be sick encounters the health services for some specific purpose, such as to receive limited care or service for a current condition, to donate an organ or tissue, to receive prophylactic vaccination (immunization), or to discuss a problem which is in itself not a disease or injury.
(b) When some circumstance or problem is present which influences the person's health status but is not in itself a current illness or injury.

chaimz

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Hello all,

Doctor documents Current Smoker. He counseled the pt on smoking cessation. However under use additional code, it states to use nicotine dependence. The only code I can use is tobacco use - z72.0. Can this be billed additionally to z71.6?

Thanks.
 

nomerz

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If the doctor lists an indication for the smoking cessation counseling (i.e. cough, shortness of breath, asthma, etc) I use that for the CPT only, otherwise I use Z72.0. I think in general, 99406-99407 are pretty hard to get paid regardless of the ICD-10 codes you use, at least in my experience.
 

erjones147

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Knock on wood, I never had a problem in 2016 getting it paid for by using F17.210 AND Z71.6. I have not had any to try in 2017, so YMMV
 

espressoguy

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It is my understanding that Z72.0 does not meet medical necessity which might explain why nomerz has trouble getting paid and erjones147 states that he/she has not had any issues getting paid with F17.210.

You might try searching the forum as this has been previously discussed.
 

chaimz

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The doctor only specified "current smoker" NOT "Cigarette dependence" - therefore I cannot use f17.210. He counseled the pt which means z71.6, but since he did not specify cigarette dependence, just current, smoker, the closest code I could use (unless even that is not specific enough) is z72.0.
 
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ehanna

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Like I said, the doctor only specified "current smoker" NOT "Cigarette dependence" - therefore I cannot use f17.210. He counseled the pt which means z71.6, but since he did not specify cigarette dependence, just current, smoker, the closest code I could use (unless even that is not specific enough) is z72.0.

It's my understanding that the only payable diagnosis codes for the seldom paid smoking cessation are the F codes. As far as sarcastic remarks in return to your questions I think if you go back and reread your responses to the people who took time to give their ideas about the subject and what works or doesn't work for them you might understand the sarcastic response.

If all you have to work with is the Z code you can bill it but it most likely won't get paid. Have a great day!
 

erjones147

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Like I said, the doctor only specified "current smoker" NOT "Cigarette dependence" - therefore I cannot use f17.210. He counseled the pt which means z71.6, but since he did not specify cigarette dependence, just current, smoker, the closest code I could use (unless even that is not specific enough) is z72.0.

Chaimz,

if the documentation is there for everyday use AND the provider felt strongly enough about the smoking to intercede medically, would that meet their standard for F17.210? Would they give you permission to change the code?
 
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chaimz

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It's my understanding that the only payable diagnosis codes for the seldom paid smoking cessation are the F codes. As far as sarcastic remarks in return to your questions I think if you go back and reread your responses to the people who took time to give their ideas about the subject and what works or doesn't work for them you might understand the sarcastic response.

If all you have to work with is the Z code you can bill it but it most likely won't get paid. Have a great day!

I just reread my response, and you're right. I could have worded it a bit nicer. With that said, thank you for answering, and pointing out my inappropriate response.
 
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