Wednesday, March 30, 2016

CPT CODE G0436, G0437 and coverage benefits

Counseling to Prevent Tobacco Use (for Asymptomatic Beneficiaries)

HCPCS/CPT Codes

G0436 – Smoking and tobacco cessation counseling visit for the asymptomatic patient; intermediate, greater than 3 minutes, up to 10 minutes

G0437 – Smoking and tobacco cessation counseling visit for the asymptomatic patient; intensive, greater than 10 minutes

ICD-10-CM Codes
F17.200, F17.201, F17.210, F17.211,
F17.220, F17.221, F17.290, F17.291, and
Z87.891

Who Is Covered

Outpatient and hospitalized Medicare beneficiaries:

• Who use tobacco, regardless of whether they exhibit signs or symptoms of tobaccorelated disease;
• Who are competent and alert at the time of counseling; and
• Who get counseling furnished by a qualified physician or other Medicarerecognized practitioner


Frequency

Two cessation attempts per year. Each attempt may include a maximum of 4 intermediate or intensive sessions, with the total annual benefit covering up to 8 sessions
per year


Beneficiary Pays
• Copayment/coinsurance waived
• Deductible waived

1 comment:

  1. These codes have officially been deleted on 9/30/2016.

    ReplyDelete

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