Reimbursement

Treating Tobacco Use and Dependence: PHS Clinical Practice Guideline

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.
Current as of December 2012
Internet Citation: Reimbursement. December 2012. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/tobacco/reimburs.html