Lost in TranslatYIN – May 2024

Dear NES Providers,
         I hope you all are doing well.  I hope that the weather is warming up wherever you may be.  I live in Cleveland and the weather is quite unpredictable here.  I make sure to enjoy the 70-degree sunny days knowing that it could snow 2 days later.  
         May’s Documentation topic is about smoking cessation.   Here are some quick facts about smoking.  Did you know that cigarette smoking causes more than 480,000 deaths each year?  Smoking is the cause of nearly one in five deaths.   Smoking kills more people every year than HIV, drug use, alcohol use, motor vehicle accidents, and guns.  People who smoke are 4 times more likely to get heart disease and stroke.  Smoking causes at least 15 types of cancers.  If nobody smoked, one of every three cancer deaths in the United States would not happen.  
          I’m sure that all of you as Medical Professionals know that smoking is bad for you.  We all signed up to be physicians, physician associates, and nurse practitioners for one reason.  That reason was to help people.  Getting patients to quit smoking is helping people.  I am sure that all of you at some point have counseled a patient about smoking cessation.  Here in Ohio, it is not uncommon for me to have to counsel a 13-year-old to help them quit smoking.  How many COPD and asthma patients have you treated that smoke?  How many patients have you seen that have CAD and stents in their heart that still smoke?  I am 100% sure that all of you are talking to your patients about quitting smoking.  However, how many of you are documenting smoking cessation correctly?  
           When you counsel a patient for smoking cessation for 3 to 10 minutes, the CPT code used is 99406.  This code accounts for 0.24 RVU.  This is not an insignificant amount of RVUs.  It’s actually the same amount of RVU for correctly documenting an EKG.  If you a counsel a patient for smoking for more than 10 minutes, the CPT code used is 99407.  99407 accounts for a whopping 0.5 RVU.  
           Here are examples of some phrases to help you correctly bill for smoking cessation.   Feel free to modify them to your own liking. For the last phrase, feel free to replace the first *** with whatever amount of time you spent counseling the patient, and the second *** with how the patient will try and cut down on their smoking. 
  1. Patient smokes.  Patient counseled on smoking cessation for 4 minutes.  Patient advised that smoking is making their condition worse.  Patient states that they will try quitting cold turkey to help with smoking cessation.  
  2. Patient counseled on smoking cessation for 11 minutes.  Patient states they will try quitting smoking with nicotine patches.  Nicotine patches prescribed today for the patient. 
  3. Patient counseled on smoking for *** minutes.  Patient states they will try quitting smoking with ***. 
            We all went into medicine to help people.  Helping people quit smoking is how we help people.  I know that you all are talking to your patients about the negative effects of smoking.  I’m just here to help you get credit for all the hard work that you are already doing.  That credit comes from correct documentation. 
Thank you all for reading.  As always, if you have any questions, please feel free to contact me.  
Humbly yours,
David Yin