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smoking cessation for Medicare

  1. Default smoking cessation for Medicare
    Medical Coding Books
    What is considered an underlying condition for smoking cessastion for Medicare? Ive always knew copd and asthma counts . But I was recently asked about diabetes and hyperlipidemia. Does this meet medical nessesity to use 99406/99407.



    Thanks

  2. #2
    Default
    This is from the cms.gov website:
    Claims for smoking and tobacco use cessation counseling services shall be submitted with an appropriate diagnosis code. Diagnosis codes should reflect: the condition the patient has that is adversely affected by tobacco use or the condition the patient is being treated for with a therapeutic agent whose metabolism or dosing is affected by tobacco use.
    NOTE: This decision does not modify existing coverage for minimal cessation counseling (defined as 3 minutes or less in duration) which is already considered to be covered as part of each Evaluation and Management (E/M) visit and is not separately billable.

    So I would query the provider to see if it exacerbates the conditions.
    Teresa Kelley, CPC
    Detroit, MI AAPC Chapter member

  3. #3
    Default
    Sorry the entire paragraph did not copy and paste for me. Here is the remainder:
    "Claims for smoking and tobacco use cessation counseling services shall be submitted with diagnosis code V15.82, history of tobacco use, or 305.1, non-dependent tobacco use disorder.
    Teresa Kelley, CPC
    Detroit, MI AAPC Chapter member

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