ED Coding & Reimbursement Alert - 2017 Issue 5
Smoking Cessation: Brush Up on ABCs of Smoking and Tobacco-Use Cessation Counseling
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Article Overview
This article explains the general scope of smoking and tobacco-use cessation counseling coverage, focusing on CPT behavior change intervention services, Medicare preventive service considerations, and documentation expectations. It is aimed at physicians, coders, and billing staff who need to understand when these services are reported, what supporting information is typically documented, and how they may relate to same-day evaluation and management services.
Why This Topic Matters
Smoking cessation counseling is a billable preventive service when documentation and reporting requirements are met, so accurate understanding of the relevant guidance affects compliance, claims processing, and reimbursement.
Article Sections
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Learn Characteristics of Behavior Change Intervention Services
Introduces the CPT behavior change intervention service category and places smoking and tobacco-use cessation counseling within that broader framework.
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Reference CMS and CPT® Guidelines to Understand 99406/99407 Requirements
Summarizes the general Medicare and CPT guidance discussed in the article for reporting smoking cessation counseling in outpatient and hospital settings.
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Master Documentation Criteria for 99406 and 99407
Covers the broad documentation elements the article highlights for supporting smoking cessation counseling claims and related diagnosis reporting.
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Ace Reporting 99406 and 99407 with E/M Services
Discusses the article’s overview of same-day reporting considerations when smoking cessation counseling is performed along with evaluation and management services.
What You Will Learn
- How the article frames smoking and tobacco-use cessation counseling within CPT behavior change intervention services
- What general CMS and CPT guidance is discussed for reporting these services
- What broad documentation elements are emphasized for supporting counseling claims
- How the article addresses coordination with same-day evaluation and management services
Who Should Read This
- Physicians
- Medical coders
- Billing staff
- Practice managers
- Compliance professionals
Codes Discussed
Modifiers Discussed
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