No Ifs, Ands or Butts - Continuing Medical Education

So, how can youget paid for your workon tobacco cessation?Medicare Payment• Effective March 22, 2005, tobaccocessation counseling covered forsmokers (8 visits annually with 4sessions per attempt)• Effective January 2006, prescriptiondrug benefit covers treatmentsprescribed by a physician (OTC notcovered)67Source: www.askandact.org 68PaymentHCPCS Billing Codes• Counseling < 3 minutes covered under E &M code• 99406: 3-10 minutes counseling ($13)1/1/08• 99407: >10 minutes counseling ($25) 1/1/08• Use modifier 25 for an appropriate E&Mservice on that same day• Face-to-Face counseling timeSource: www.askandact.org 69http://www.momedicare.com/provider/viewarticle.aspx?pf=yes&articleid=5685Payment• If plans cover counseling use ICD-9 Codes• 305.1 Tobacco Dependence• 292 Nicotine Withdrawal• V15.82: History of Tobacco Use• Provide clinically relevant diagnosis code suchas; cough 786.2 or lung cancer 162• Document time spent counselingSource: www.askandact.com70Private InsurersMost insurers provide coverage for at leastone type of pharmacotherapy for tobaccocessation and at least one type ofbehavioral intervention.Source: www.askandact.org71Private Insurers• Use billing codes in the categories of:• Preventive Medicine Treatments• Tobacco Dependence Treatment aspart of the initial or periodiccomprehensive preventive medicineexam• Tobacco Dependence Treatment asspecific counseling and/or risk factorreduction72www.askandact.org12