Wiki Tobacco cessation code along w/ office visit

[Kentuckygirl1984]

I am a coder for a pulmonology office and on a everyday basis the doctor will see the patient in the office for a follow up or a new pt either using a office visit code or new patient code and if the patient smokes they will document how many minutes they discuss smoking. My question is would I add a modifier 25 to the office visit code or does it not require a 25 since it is including in the visit? Thanks

 

[krishna.k]

It depends on insurance. You need to add 25 modifier for certain insurances like MC & BCBS.

 

[ehanna]

I am a coder for a pulmonology office and on a everyday basis the doctor will see the patient in the office for a follow up or a new pt either using a office visit code or new patient code and if the patient smokes they will document how many minutes they discuss smoking. My question is would I add a modifier 25 to the office visit code or does it not require a 25 since it is including in the visit? Thanks

There are separate smoking cessation codes that are payable and you would use a -25 modifier on the office level.

Look at codes 99406/99407 (commercial insurance) and G0437/G0438 (Medicare insurance)

you would use 305.1 for a current smoker diagnosis and V15.82 for history of.

 

[Kentuckygirl1984]

Thank you so much I really appreciate the feedback.