What is the CPT code 99406?

Counseling to the patient: Smoking and tobacco use counseling to the patient is reported using CPT code 99406 (smoking and tobacco cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes) or code 99407 (smoking and tobacco cessation counseling visit; intensive, greater than 10 minutes).

Can 99406 and 99407 be billed together?

99407 is not an add-on code, and the two codes are never reported together.

Does Medicare pay for CPT code 99406?

Medicare covers 2 cessation attempts per 12-month period. Each attempt includes a maximum of up to 4 intermediate (99406) or intensive (99407) counseling sessions, with a total Medicare benefit of 8 sessions per year. A modifier 25 may be appropriate to append to the primary E/M visit code.

Is CPT 99406 An E M code?

Medicare covers 2 cessation attempts per year. The counseling during an E/M service must be either intermediate or intensive. These services are reported using CPT-4 code 99406 (intermediate, E/M counseling service) or code 99407 (intensive, E/M counseling service).

How often can 99406 be billed?

The 2019 CMS guidelines state that Medicare covers two cessation attempts per 12-month period. Each attempt includes a maximum of up to four intermediate (99406) or intensive (99407) counseling sessions, with a total Medicare benefit of eight sessions per year.

What is it called when you stop smoking?

Smoking cessation, usually called quitting smoking or stopping smoking, is the process of discontinuing tobacco smoking.

How often can 99497 be billed?

Are there limits on how often I can bill CPT codes 99497 and 99498? Per CPT, there are no limits on the number of times ACP can be reported for a given beneficiary in a given time period. Likewise, the Centers for Medicare & Medicaid Services has not established any frequency limits.

Can nurses bill for smoking cessation?

In addition to the previously published list of providers of smoking cessation, local health departments can bill for these services when provided by an RN who has demonstrated competence in the tobacco cessation program in use in their agency.

What can I replace smoking with?

They don’t take a lot of effort or time, but they’re enough to replace the habit of grabbing for a cigarette.

• Drink a glass of water.
• Eat a dill pickle.
• Suck on a piece of tart candy.
• Eat a popsicle or wash and freeze grapes on a cookie sheet for a healthy frozen snack.
• Floss and brush your teeth.
• Chew gum.

How long does smokers flu last?

The symptoms of smoker’s flu will resolve themselves with time. Unfortunately, that could take two weeks or more. While you’re coping with the smoker’s flu, you can focus on treating the symptoms.

Can you bill G0439 with 99497?

This year also Medicare made it clear that you can bill the advance care planning codes 99497 and 99498 along with an annual wellness visit (AWV) code G0438 or G0439. CPT codes 99497 and 99498 used to describe ACP are separately payable under the Medicare Physician Fee Schedule (MPFS).”

Can you bill 99497 alone?

Is code 99497 always billed first? Yes. Code 99497 must always be billed for the first 30 minute period of the ACP discussion. If the conversation lasts longer, 99498 (the add-on code) may be billed for each additional 30 minutes of the ACP discussion, with no limit.

How much does smoking cessation counseling 99406 cost?

The 10 minute or longer consult may not apply to everyone. The 3 to 10 minute counseling code, 99406, reimburses $15.70. These are national reimbursement amounts, your local Medicare payments may vary.

How to check Medicare for CPT 99406 codes?

Also CPT 99406 look up the NCD 210.4.1 policy for the medically necessary ICD 10 codes. Medicare denied all 99406 ( Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes) codes with my e/m code.

What are the CPT codes for smoking cessation?

CPT ® codes for Smoking Cessation. There are two codes used to report counseling by a physician or non-physician practitioner (NPP) with the patient for smoking cessation. 99406 Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes 99407 Smoking and tobacco use cessation counseling visit;

Is there an add on code for 99407?

99407 is not an add-on code, and the two codes are never reported together. Report only one of the codes, depending on the time of the counseling. According to Medicare, a physician or “other Medicare-recognized practitioner” may perform the service.