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Smoking Cessation

James Posted Mon 28th of March, 2016 17:50:38 PM

I need help with coding Medicare for smoking cessation. The doctor counseled the patient for 3 minutes. Dx code F17.210 and CPT code G0436 was used and was rejected because, RETURNED AS UNPROCESSABLE CLAIM SMARTEDIT LBI PER LCD OR NCD GUIDELINES PROCEDURE CODE G0436 HAS NOT MET THE ASSOCIATED DIAGNOSIS CODE RELATIONSHIP CRITERIA FOR CMS IDS 210.4.1. Can some please explan this to me.

Thank you.

SuperCoder Answered Tue 29th of March, 2016 05:44:06 AM

Thanks for the Query

As per CMS IDS 210.4.1 Diagnosis codes that should be reported for this service are ICD 10 CM codes F17.2 (Nicotine dependence) and Z87.891
(Personal history of nicotine dependence).Both the deductible and co-
pay/coinsurance are waived for this service. For further assistance follow undermentioned links
https://www.acog.org/-/media/Departments/Coding/Medicare-Preventive-Services-2015.pdf?la=en
https://www.cms.gov/Medicare/Prevention/PrevntionGenInfo/Downloads/MPS-QuickReferenceChart-1TextOnly.pdf

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