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Tobacco Cessation Counseling

  1. #1
    New Braunfels, Texas
    Default Tobacco Cessation Counseling
    Medical Coding Books
    Hi! I work for an OBGYN office and have noticed that our doctors are using the Tobacco Cessation Counseling codes 99406. Does anyone out there know what the difference is between 99406 and G0436? 99406 states: smoking and tobacco - use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes. G0436 states: smoking and tobacco cessation counseling visit for the asymptomatic patient; intermediate, greater than 3 minutes, up to 10 minutes. Is the G codes used just for medicare patients. Any response will be greatly appreciated.

  2. #2
    Thats how I use them in my OB office. I bill HCPCS to medicare and 99406 to all others including medicaid. Sometimes BCBS will take HCPCS. I'm in NY and BCBS has pd HCPCS before but I usually bill CPT
    Hope thats helpful

  3. #3
    Indianapolis, Indiana
    Thumbs up
    99406 & 99407 can be billed to Medicare if the patient uses tobacco and has an disease or adverse health effect linked to tobacco use or currently takes medicine that would be adversely affected by tobacco use. The new G codes - G0436 & G0437 are Medicare codes only and are to be used for counseling when the patient does not have a disease process/taking meds (as above). They are "asymptomatic" - meaning they have not been diagnosed with anything (ie: COPD, etc) but currently use tobacco. It is part of the new preventive medicine that Medicare now covers. As far as I know, commercial insurance pays the 99406 & 99407 with just the 305.1 ICD-9 code, but Medicare would require additional diagnosis with the 305.1 to bill 99406 & 99407.

  4. #4
    New Braunfels, Texas
    I really appreciate your reponse! This really helps.

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