Forum - Questions & Answers

Jul 26th, 2012 - rfiore 1 

smoking cessation

Why is Medicare denying CPT® code 99407, smoking cessation counseling, as included in another service that has already been adjudicated? Is there a modifier I should be attaching? I billed an office visit, cryo, and smoking cessation. Modifier 25 was put on the office visit.

Jul 26th, 2012 - Sha12 62 

re: smoking cessation

Use G0436 Smoking & Tobacco Cessation 3-10mins or G0437 Smoking & tobacco cessation >10 mins. for Medicare. Needs Mod. 25 in the E/M code.
*For counseling provided to asymptomatic patients beginning on Jan. 1, 2011, you should bill using the new Medicare G codes: G0436, "Smoking and tobacco cessation counseling visit for the asymptomatic patient; intermediate, greater than 3 minutes, up to 10 minutes," or G0437, "Smoking and tobacco cessation counseling visit for the asymptomatic patient; intensive, greater than 10 minutes." The same diagnosis codes, 305.1 or V15.82, will be required. Again, patients will not have an out-of-pocket expense for these services when they are delivered on Jan. 1, 2011, or after.



Home About Terms Privacy

innoviHealth® - 62 E 300 North, Spanish Fork, UT 84660 - Phone 801-770-4203 (9-5 Mountain)

Copyright © 2000-2024 innoviHealth Systems®, Inc. - CPT® copyright American Medical Association