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The Ottawa Model for Smoking Cessation in 120 hospitals across Canada identifies the smoking status of all admitted patients, followed by brief advice, personalised bedside counselling, timely nicotine replacement therapy and/or pharmacotherapy, and follow-up after discharge 27.
MSCAN Tobacco Cessation Coverage If billed alone, 99406 and 99407 are reimbursed. When billed with another evaluation and management code, the codes will bundle to a single fee. To allow payment in this circumstance, providers should append a 25 modifier for 99406 or 99407 codes.
Description of CPT code 99406 & 99407 CPT code 99407 is not an add-on code, and the two codes are never reported together. Report only one of the codes, depending on the time of the counseling.
Smoking Cessation Counseling Codes 99406 and 99407Medicare covers 2 cessation attempts per 12-month period. Each attempt includes a maximum of up to 4 intermediate (99406) or intensive (99407) counseling sessions, with a total Medicare benefit of 8 sessions per year.
The options include:Prescription nicotine in a nasal spray or inhaler.Over-the-counter nicotine patches, gum and lozenges.Prescription non-nicotine stop-smoking medications such as bupropion (Zyban) and varenicline (Chantix)
5 Stages to QuittingPre-contemplation (not thinking about quitting)Contemplation (thinking about quitting but not ready to quit)Preparation (getting ready to quit)Action (quitting)Maintenance (remaining a non-smoker)16-Feb-2009
The US Preventive Services Task Force (USPSTF) recommends using the 5 As model; ask, advise, assess, assist and arrange.
Initial therapy selection First-line pharmacotherapies for smoking cessation include nicotine replacement therapy (NRT), varenicline, and bupropion (table 1) 1,2,7-9. These treatments aim to reduce symptoms of nicotine withdrawal, thereby making it easier to stop using cigarettes.
Successful intervention begins with identifying users and appropriate interventions based upon the patient's willingness to quit. The five major steps to intervention are the "5 A's": Ask, Advise, Assess, Assist, and Arrange. Ask - Identify and document tobacco use status for every patient at every visit.