Home HealthTopics Health Centers Reference Library Research
Join us on Facebook Join us on Facebook Share on Facebook

Smoking and Tobacco

Smoking cessation and a physical exam

06/17/2008

Question:

Is smoking cessation included in the annual physical exam? If not, can it be billed separately with an E&M code?

Answer:

I assume I'm corresponding with a provider of services, so I'm going to refer you to a Medicare/Medicaid bulletin that covers these areas.  However, let me also briefly outline what can and should be done.
 
1)  Brief counseling -- under 3 minutes is not billable -- but is demonstrably effective.  I suggest to my residents that they ASK everyone if they smoke, ADVISE smokers to quit in no uncertain terms, REFER them to 800-QUIT-NOW and PRESCRIBE for them nicotine replacement, buproprion or verenicline.  I tell my residents to help retire smoking (AARP).
 
2)  If that runs more than 3 minutes, you may bill one of two "G" codes: G0375 for 3-10 minutes, or G0376 for greater than 10 minutes. These can be billed separately or combined with a modifier 25 if a 99211-15 for another E/M is billed on the same visit.
 
For the full technical scoop visit:
 
http://www.cms.hhs.gov/Transmittals/Downloads/R562CP.pdf
 
or
 
http://www.aarc.org/resources/tobacco/MSSmokingCessation.pdf
 
Keep in mind that the premature mortality for continuing smokers is FIFTY PERCENT, and the number one reason people quit is "my doctor told me to."

For more information:

Go to the Smoking and Tobacco health topic, where you can:

Response by:

Rob  Crane, MD Rob Crane, MD
Clinical Associate Professor of Family Medicine
College of Medicine
The Ohio State University