Uploaded image for project: 'eCQM Issue Tracker'
  1. eCQM Issue Tracker
  2. CQM-1392

Question regarding CPT codes satisfying smoking cessation counseling

XMLWordPrintable

    • Icon: EH/CAH eCQMs - Eligible Hospitals/Critical Access Hospitals EH/CAH eCQMs - Eligible Hospitals/Critical Access Hospitals
    • Resolution: Delivered
    • Icon: Minor Minor
    • Guidance, Measure
    • Please see ATTACHED email and referral from QNET Support
    • 617-402-1894
    • athena Health
    • Therefore my question is: If a provider is unable to bill for a 99406/99407 CPT code, but still advises the patient to quit smoking (< 3 minutes) should this action by the provider satisfy the measure?
    • The answer to the question is yes. If the provider does not meet the billing criteria but still advises the patient to quit smoking (<3 minutes), then they do satisfy the measure.
    • CMS138v3/NQF0028
    • CMS138v2:

      Hi,

      I am looking to get some clarification on satisfying measure CMS138v2: Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention. As an EHR vendor athena has built the measure into the software to satisfy if the provider has billed for :

      99406 – Smoking and Tobacco use cessation counseling visit; intermediate, greater than 3 minutes to 10 minutes.
      Or
      99407 – Intensive, greater than 10 minutes

      However, one of our clients raised the question - that if a provider is not able to meet the requirements to bill the patient for one of these two CPT codes above, but the provider still advises the patient to quit smoking, this should satisfy the measure. Specifically , in the eMeasure specifications it states:

      “Minimal interventions lasting less than 3 minutes increase overall tobacco abstinence rates. Every tobacco user should be offered at least a minimal intervention whether or not he or she is referred to an intensive intervention.”

      Therefore my question is: If a provider is unable to bill for a 99406/99407 CPT code, but still advises the patient to quit smoking (< 3 minutes) should this action by the provider satisfy the measure?

      Thank you,

      Dan MacNulty | Clinical Quality Associate
      athenahealth | 311 Arsenal Street | Watertown, MA 02472
      O: 617.402.1894 | F: 617.402.1099 | athenahealth.com
      Physician Practice Management, EHR, and Patient Communication ServicesSM
      there is a better way

            edave Mathematica EC eCQM Team
            dmacnulty Dan MacNulty (Inactive)
            Alexis Isabelle (Inactive), Rebecca Grando (Inactive), Samantha Wang (Inactive)
            Votes:
            0 Vote for this issue
            Watchers:
            3 Start watching this issue

              Created:
              Updated:
              Resolved:
              Solution Posted On: