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Wednesday, June 19, 2013
Smoking and Tobacco
Smoking cessation and a physical exam
Is smoking cessation included in the annual physical exam? If not, can it be billed separately with an E&M code?
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:orKeep 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."
Rob Crane, MD
Clinical Associate Professor of Family Medicine
College of Medicine
The Ohio State University