Smoking Cessation Codes

Question: I know I can use G codes to bill Medicare for smoking cessation. Can I use them to bill private payers as well? Also, if I see someone with bronchitis and charge a 99213 but also perform tobacco counseling, how would I code?

Answer: The G codes are for Medicare only, but many private payers will also reimburse if you use an ICD-9 code for tobacco dependence (305.1) with a CPT code for preventive risk counseling (99401-99404).

As for your second question, codes 99401 through 99404 serve “to report services provided to individuals at a separate encounter for the purpose of promoting health and preventing illness or injury. … These codes are not to be used to report counseling and risk factor reduction interventions provided to patients with symptoms or established illness,” according to CPT. However, you can recognize your counseling work when selecting an E&M level. Indeed, if counseling about risk factors constitutes more than 50 percent of the visit, you can designate an E&M code based on time. List in your documentation the time spent on counseling, noting specifically what you discussed.