AMA CPT® Assistant - 2009 Issue 9 (September)
Evaluation and Management/Preventive Medicine Services (September 2009)
September 2009 page 11 Evaluation and Management: Preventive Medicine Services, 99406, 99407 (Q&A) Question: In a pediatric practice, we often provide tobacco cessation counseling to parents in front of their children. There is clear evidence of the adverse effects of second hand smoke on children. We have an interesting dynamic in pediatric reporting in which the patient is the child. We cannot bill the parents' insurance for counseling the mother and/or father, the smoker(s) in the house. If we are providing the service to the parent, can we report 99406 and 99407 for smoking cessation counseling to the...
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Article Overview
This article explains a coding question from pediatric practice involving tobacco cessation counseling delivered in the presence of a child but directed to a parent or caregiver. It is relevant for coders, billers, and compliance staff who work with CPT preventive medicine and evaluation/management services, especially when counseling, documentation, and the reported recipient of the service must be distinguished.
Why This Topic Matters
The guidance helps readers understand how the article frames reporting issues when counseling is provided in a family context rather than directly to the patient on the claim. It also highlights the broader distinction between preventive medicine services and office or other evaluation and management reporting in pediatric care.
Article Sections
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September 2009 page 11
A short issue/page marker identifying the publication context for the Q&A.
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Evaluation and Management: Preventive Medicine Services, 99406, 99407 (Q&A)
A question-and-answer discussion addressing tobacco cessation counseling in a pediatric setting and how the topic relates to CPT preventive medicine and evaluation and management reporting.
What You Will Learn
- How the article frames counseling provided to a parent or caregiver in relation to a child’s visit
- How the article distinguishes preventive medicine services from evaluation and management services in this context
- What kinds of documentation concerns are discussed for counseling-related services in pediatric practice
- Which CPT® concepts are involved in the Q&A format covered by the article
Who Should Read This
- Medical coders
- Billing staff
- Compliance personnel
- Pediatric practice administrators
- Physician office staff
Codes Discussed
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