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Smoking Cessation Code 99406

  1. #1
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    Default Smoking Cessation Code 99406
    Medical Coding Books
    What are the documentation requirements for using the smoking cessation code of 99406? Can anyone point me to a reference that states what the documentation requirements are? If the provider just documents: "Smoking counseling, 10 mins" and uses 305.1 as the dx, is this enough documentation to justify the use of this code? Thanks.
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P, CRHC, AAPC Fellow
    Coder

  2. #2
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    Cindy Hughes CPC

    Cindy Hughes is the AAFP's coding and compliance specialist and is a contributing editor to Family Practice Management.

    Tobacco cessation codes
    Q What do I need to do to get paid for smoking and tobacco cessation education using codes 99406 and 99407? What are the documentation requirements?

    A Codes 99406 and 99407 replaced G0375 and G0376, which previously were used to report these services. You must document the following:

    • The patient's tobacco use;
    • The patient's conditions adversely affected by tobacco use or the therapeutic agent affected by tobacco use;
    • The amount of time spent on tobacco cessation counseling and the context in which it was provided.
    The code should be selected based on the amount of time devoted to the counseling; use 99406 for 3 to 10 minutes or 99407 for more than 10 minutes

    You may want to take at look on page 30, also~

    http://www.medicarenhic.com/provider.../preventgd.pdf

    I hope this was enough information.

  3. #3
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    This is perfect! Thanks so much!
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P, CRHC, AAPC Fellow
    Coder

  4. Default 99406
    If you were to code this with another seperate and identifiable EM would you append modifier 25 to the 99406?

  5. #5
    Default Modifier 25
    Take a look at this article.
    http://www.medscape.com/viewarticle/585560
    Heather Winters, CPC, CFPC

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