ED Coding & Reimbursement Alert - 2017 Issue 10
You Be the Coder: Look to 99406 and 99407 for Smoking and Tobacco-Use Cessation Counseling
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Article Overview
This article explains a coding question about smoking and tobacco-use cessation counseling and summarizes the related CPT and CMS Medicare preventive-services guidance. It is relevant to coders, billers, and compliance staff who work with outpatient or hospital preventive services and need to understand the general scope of documentation, coverage, and billing considerations discussed in the article.
Why This Topic Matters
Smoking cessation counseling is a commonly reported preventive service, and correct handling of the associated CPT coding and Medicare preventive-service requirements can affect claim processing and patient cost-sharing. The article also addresses broader behavior-change counseling context and the inclusion of a billing modifier used to indicate preventive services.
What You Will Learn
- How the article frames smoking and tobacco-use cessation counseling within CPT guidance
- What general CMS Medicare preventive-services considerations are discussed
- Why the article emphasizes preventive-service billing and patient cost-sharing
- What broad documentation and patient eligibility concepts are referenced in the counseling context
Who Should Read This
- Medical coders
- Medical billers
- Compliance staff
- Physician practice staff
- Revenue cycle professionals
Codes Discussed
Modifiers Discussed
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