Tag Archives: 99406
Medicare Covers 99406, 99407
Posted on 13. Dec, 2010 by jennifer.godreau.
If you’ve been writing off tobacco cessation counseling as non-payable, it’s time to change your tune.
The change: In the past, you could collect for tobacco cessation counseling for a patient with a tobacco-related disease or with signs or symptoms of one. But on Aug. 25, CMS announced that “under new coverage, any smoker covered by Medicare will be able to receive tobacco cessation counseling from a qualified physician or other Medicare recognized practitioner who can work with them to help them stop using tobacco.”
“For too long, many tobacco users with Medicare coverage were denied access to evidencebased tobacco cessation counseling,” said Kathleen Sebelius, HHS secretary, in an Aug. 25 statement. “Most Medicare beneficiaries want to quit their tobacco use. Now, older adults and other Medicare beneficiaries can get the help they need to successfully overcome tobacco dependence.”
Count Attempts and Minutes
The new tobacco cessation counseling coverage expansion will apply to services under Medicare Part B and Part A. That means your physicians and coders should know how to correctly document and report the sessions.
“Medicare allows billing for two counseling attempts in a year, but each attempt can occur over multiple sessions, with
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CPT 99406, 99407 Coverage Extended to All Smokers
Posted on 31. Aug, 2010 by jennifer.godreau.
CMS announcement is triumph for physicians who haven’t collected in the past.
If you’ve been writing off tobacco cessation counseling as non-payable, it’s time to change your tune.
In the past, CMS only covered 99406-99407 (Smoking and tobacco use cessation counseling visit…) for a beneficiary with a tobacco-related disease or with signs or symptoms of one. But on Aug. 25, CMS announced that “under new coverage,
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Medical Coding: Ease Counseling Codes Acceptance With Distinct Dxs
Posted on 14. Jun, 2010 by Editor.
Study frequency guidelines before you bill for counseling services.
Question: A 60-year-old established Medicare patient with a confirmed diagnosis of vanishing lung (emphysema) reports to the family physician (FP) for a medication check and blood work; the patient is a moderate smoker. During the medication check and blood work, which took about 5 minutes, the patient tells the practice’s non-physician practitioner (NPP) “I think I’m ready to quit smoking; can you help?” The NPP spends the next 7 minutes providing smoking cessation counseling for the patient. Can I report a cessation code and an E/M?
Answer: Provided the patient meets Medicare’s requirements for cessation counseling, you can report the following:
- 99211 (Office or other outpatient visit for the evaluation and management of an established patient, that may not require the presence of a physician. Usually, the presenting problem[s] are minimal. Typically, 5 minutes or less are spent performing or supervising these services.) for the E/M
- 492.0 (Emphysema; emphysematous bleb) appended to
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Time-Saving Forms for Coding Cessation Counseling
Posted on 01. Apr, 2009 by .
We’ve got the DAST, CAGE inks to help you make your templates.
Use of cessation counseling codes 99406-99409 is rising and payers are starting to reimburse for them, experts say.
Get on board with others reporting these codes to add between $11 and $32 for each encounter that meets the guidelines for tobacco or drug/alcohol abuse counseling.
AUDIO: Learn what CMS auditors expect on smoking cessation documentation, with Jennifer Godreau.
Use Template to Focus Exam Elements
To report a behavior change intervention code, there must be a “face-to-face interaction by a physician or other qualified healthcare professional that involves specific validated interventions,” explains Caral Edelberg, CPC, CCS-P, CHC, president of Medical Management Resources for TeamHealth in Jacksonville, Fla.
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Smoking Cessation Codes: 99406, 99407 Truths Revealed
Posted on 04. Mar, 2009 by .
Now that 99406 and 99407 are no longer new codes, some payers are creating ‘payment cessation’ policies. Bust these myths regarding coding for stop-smoking counseling to make sure your practice’s expected reimbursement does not go up in smoke.
Myth 1: You Need a Plan and Referral to Support 99406, 99407
“Last year, I was told as long as the doctor noted he advised on the risks, advised the patient to quit, gave an Rx, it would support 99406,” recalls Kathleen Goodwin, coding coordinator at LaPorte Regional Physicians Network in Indiana. “How much documentation is needed to support 99406, which is for 3-10 minutes of smoking cessation counseling, and 99407, which is for more than 10 minutes of counseling?” she asks.
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Smokin’ PQRI Pointers
Posted on 29. Jan, 2009 by .
We’ve got the G codes you need to score your bonus, plus links to PQRI hot spots.
No butts about it: If you code and document your practice’s smoking cessation efforts, you could earn a little extra cash from CMS.
Measure 115: CMS’s Physician Quality Reporting Initiative (PQRI) has as one of its measures smoking cessation help. To participate in this measure (and earn your bonus), your office must report on the percentage of patients aged 18 years and older who are smokers and who received advice to quit smoking. This measure is to be reported a minimum of once per reporting period for all Medicare patients seen during the reporting period, (whether or not they use tobacco). There is no diagnosis associated with this measure.
Plus, Jill Young explains when ‘family’ meetings count as critical care.
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