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Thread: TOBACCO CESSATION (cpt 99406)

  1. #1

    Default TOBACCO CESSATION (cpt 99406)

    AAPC: Back to School
    Hi, has anyone out there billed out the smoking cessation code 99406 with modifier 33? If so, what is the appropriate icd 9 code you are using?. There is 305.1 (tobacco dependence) or V15.82 (history of tobacco smoking). The ob/gyn doctors I work for have been using V15.82 even though the patient is still a smoker. To my understanding V15.82 is used for history of (no longer a smoker). Am I correct? Also, can the doctor still counsel a patient on smoking, even though the patient is not longer a smoker?

  2. #2
    Join Date
    Apr 2007
    Dover Seacoast New Hampshire


    Use codes 99406 (and 99407) when the patient has a condition, such as COPD or asthma, that is exacerbated by tobacco use (or history of tobacco use). CPT describes these codes as behavior change intervention-- performed as part of the treatment or condition (i.e. COPD) related to or potentially exacerbated by the behavior. It does go on to say that these codes can be used for the patient who doesn't yet have a related illness, but I've found that it's better to use G0436 and G0437 for the asymptomatic patient (code 305.1 or V15.82).

    Coverage of these codes vary by carrier. Some carriers simply do not cover this service, or they expect you to bundle it into your E&M. Sometimes you have to query the payer to see what procedure codes they prefer.
    Pam Brooks, MHA, CPC, PCS, COC
    Coding Manager
    Wentworth-Douglass Hospital
    Dover, NH 03820

    If you can dream it, you can do it. Walt Disney

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