Treating Tobacco Use and Dependence: PHS Clinical Practice Guideline

Reimbursement

Tobacco dependence treatments (both pharmacotherapy and counseling) should be included as a paid or covered benefit by health benefit plans because doing so improves utilization and overall abstinence rates.

• Clinicians, clinic administrators, and health care delivery systems require appropriate diagnostic and billing codes for the documentation of reimbursement for tobacco-dependent patients.
• The PHS Clinical Practice Guideline, Treating Tobacco Use and Dependence, offers diagnostic codes (ICD-9-CM) and billing codes for the treatment of tobacco dependence. (Select for ICD-9-CM codes.)
• A systems-based approach will facilitate the understanding and use of such codes by clinicians. Various clinic or hospital meetings (e.g., business sessions, grand rounds, seminars, and coding in-service sessions) can explain and highlight the use of tobacco dependence codes for diagnosis and treatment.
• These diagnostic codes can be preprinted on the billing and diagnostic coding sheets and checked off rather than expecting clinicians to recall and manually document the treatment.
• Clinicians can be reminded that counseling by itself is a reimburseable activity and can be billed, based on time spent.

Internet Citation:

Reimbursement. U.S. Public Health Service. http://www.surgeongeneral.gov/tobacco/reimburs.htm

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Tobacco Cessation Guideline Index
Department of Health and Human Services