Forum - Questions & Answers
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.
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.