News and Updates >> Client Update
September 21, 2005
Coding Update: Smoking Cessation and Medicare
Courtesy of Coding Consultants of NY, LLC (see information below!)
Effective 3/22/2005 Medicare implemented new “G” codes for smoking cessation counseling. These can be
used as a procedure code in conjunction with an E/M code. If you council someone with Medicare on tobacco
cessation, they must have an illness that is directly affected by tobacco use. Examples include COPD, Asthma,
Diabetes, CAD, and many others. You must include those conditions in your ICD-9 coding in order to justify
payment. Medicare covers a total of 8 counseling sessions per 12 month period. They cover two attempts by
the patient per year and up to four billable sessions per attempt.
G0375 : Means counseling on tobacco cessation for a minimum of 3 minutes and a maximum of 10 minutes. This
is considered intermediate level counseling. Less than 3 minutes is considered bundled into the E/M
code and not separately billable.
G0376: Means counseling on tobacco cessation for greater than 10 minutes in one visit. This is
considered intensive counseling.
Claims with date of service prior to 3/22/05 - you are unable to bill this service.
Claims with date of service from 3/22/05 – 7/04/05 should be billed using an unlisted code 99199.
As of date of service 7/5/05 use these:
| CPT | Pays | Description |
|---|---|---|
| G0375 | $12.89 | Intermediate counseling 3-10 min |
| G0376 | $25.01 | Intensive counseling > 10 min. |
Looking for information from Medicare website on Tobacco cessation counseling?
Try this web site: http://www.cms.hhs.gov/manuals/transmittals/comm_date_dsc.asp
Once you go to this website, scroll down using the third column until you reach date 5/20/05 and you
can click on the underlined number in the second column to open the manual.
PhyLogic Note: This article comes to you courtesy of "The Coding Chronicle," a publication of
Coding Consultants of NY, LLC. It’s purpose is to provide Physicians, NP’s, PA’s, CNM’s, Nurses,
Billing and Office Staff members important news and insight into the frontline medical coding. As the
editor of the Chronicle, Dr. Ronald Pope has the unique viewpoint of a practicing Family Physician who
deals with the same issues each of our readers deal with on a daily basis. He has a board
certification as an Advanced Coding Specialist in Family Practice and Pediatrics through the
Board of Advanced Medical Coders (BAMC). Dr. Pope’s goal is to teach the reader how to code
properly, increase revenue and decrease errors in documentation and coding.
PhyLogic subscribes to "The Coding Chronicle" and has found it to be extremely interesting and
helpful. We recommend it highly. For more information or to subscribe to this publication, please
visit their website at: www.codingconsultantsofny.com