A Healthcare Operations Consulting Company, Coding and Documentation Reviews Audits, Utilization Prior Authorization, Credentialing, Patients Access and Healthcare Financial Management Consulting Company | GoHealthcare Consulting and Business Development,
  • Who We Are
  • Services and Expertise
  • Testimonials
  • CONTACT US
  • BLOG
  • Readers Questions
  • Read More
  • Resources

hOW TO BILL FOR SMOKING CESSATION Counseling

2/20/2018

0 Comments

 
Do you know that you can bill for a Smoking Cessation Face-to-face encounter? But the question that you may have is how do you bill for Smoking Cessation Counseling?

Here are your codes:
99406 Intermediate Smoking and tobacco use cessation counseling visit is greater than three minutes, but not more than 10 minutes

99407 Intensive Smoking and tobacco use cessation counseling visit is greater than 10 minutes

Diagnosis that Meets Medical Necessity (always refer to your payer's guidelines too!)
F17.200 Nicotine dependence, unspecified, uncomplicated
F17.201 Nicotine dependence, unspecified, in remission
F17.210 Nicotine dependence, cigarettes, uncomplicated
F17.211 Nicotine dependence, cigarettes, in remission
F17.220 Nicotine dependence, chewing tobacco, uncomplicated
F17.221 Nicotine dependence, chewing tobacco, in remission
F17.290 Nicotine dependence, other tobacco product, uncomplicated
F17.291 Nicotine dependence, other tobacco product, in remission
Z87.891 Personal history of nicotine dependence

How do you bill Smoking Cessation code with the EM  or Evaluation and Management codes?

Append your Modifier 25 to the E/M Code and not on the Smoking Counselling Code!

Make sure you know the guideline of Modifier 25 and always know how to identify necessity.

Modifier -25, Significant, separately identifiable evaluation and management
service by the same physician on the same day of the procedure or other
service:


This modifier must be appended with an E/M service. This is the modifier you will need to use 
with the evaluation and management service done on the same day with other procedure done 
by the same physician. It has to be above and beyond the usual preoperative and postoperative 
encounter with the procedure. In fact, by using this modifier, it doesn't have to have a different 
diagnosis reported. The most important thing is that, the E/M level should meet its key 
components or if it is selected based on time with the patient (counseling and coordination). You 
have to be careful in using this modifier. It must meet medical necessity. As you know, there are 
procedures that already includes all other care and management.

Let's describe this modifier 25:

A patient came in for her monthly follow up for her chronic back pain. At the same time, patient 
was complaining with severe headache. The pain doctor performed bilateral occipital block on 
the patient at the time of service. You will append modifier 25 for the E/M code to indicate that both 
services were rendered on the same day.

You don't use modifier 25 with E/M encounter that resulted to Decision for Surgery (we have 
another modifier for this!)


RSS Feed

View my profile on LinkedIn

Categories

All
Medical Modifiers
Pain Management Billing
Revenue Cycle
You Be The Biller
Your Be The Coder

0 Comments

Your comment will be posted after it is approved.


Leave a Reply.

    Picture
    ABOUT THE AUTHOR:
    Ms. Pinky Maniri-Pescasio is the Founder of GoHealthcare Consulting. She is a National Speaker on Practice Reimbursement and a Physician Advocate. She has served the Medical Practice Industry for more than 25 years as a Professional Consultant.

    READERS QUESTIONS

    search here


    RSS Feed

    Archives

    January 2021
    October 2020
    September 2020
    August 2020
    July 2020
    June 2020
    April 2020
    March 2020
    December 2019
    February 2019
    August 2018
    February 2018
    January 2018
    December 2017
    September 2017
    August 2017
    June 2017
    May 2017
    February 2017
    October 2016


    Categories

    All
    10 Common Reasons Claims Gets Denied And Reject
    2019 New CPT Codes Medicare Payments For Virtual Services Remote Monitoring Interprofessional Consultation
    Chronic Care Management In 2017 Changes
    Medical Modifiers
    Pain Management Billing
    READER'S QUESTION
    Revenue Cycle
    Spinal Fusion Billing And Coding
    When To Use Medicare's ABN Advanced Beneficiary Notice Claim Reporting Modifiers
    You Be The Biller
    Your Be The Coder

    RSS Feed


    BROWSE HERE

    All
    10 Common Reasons Claims Gets Denied And Reject
    2019 New CPT Codes Medicare Payments For Virtual Services Remote Monitoring Interprofessional Consultation
    Chronic Care Management In 2017 Changes
    Medical Modifiers
    Pain Management Billing
    READER'S QUESTION
    Revenue Cycle
    Spinal Fusion Billing And Coding
    When To Use Medicare's ABN Advanced Beneficiary Notice Claim Reporting Modifiers
    You Be The Biller
    Your Be The Coder


Services:
Full Revenue Cycle Management 
98% of the time your claims can get paid
Cash flow increase up to 35% in 90 days
​Accounts Receivables Management
Denial Management
Motor Vehicle Cases
Workers Compensation Cases
Prior Authorization Process
Coordination of surgical orders management
Prior-to-insurance eligibility and coverage verification
Utilization and medical policy review
Medical necessity evaluation and screening
Financial clearance process
Patients Access ​
​Patients Registry and Initial Demographic Entry
Patients Scheduling and Confirming Appointments
Coordination of prior-to-encounter orders management
Prior-to-encounter insurance verification
Obtaining Referral 
Obtaining Prior Authorization
Obtaining Peri Operative Orders
Financial Counseling
Insurance Credentialing and Contracting
Payers' Contract Fees Negotiations
Documentation Review
Evaluation and Management Coding Review
Surgical Coding Review
Compliance Program
Office and Surgical Scheduling
(small or huge organization we can easily help you!

Picture

CALL US TODAY:  1 (800) 267-8752
© COPYRIGHT 2019 GoHealthcare Consulting and Business Development LLC. ALL RIGHTS RESERVED.
  • Who We Are
  • Services and Expertise
  • Testimonials
  • CONTACT US
  • BLOG
  • Readers Questions
  • Read More
  • Resources