How To Use HCPCS Code G9458

HCPCS code G9458 describes the documentation of a patient as a tobacco user who has received tobacco cessation intervention. This code is used to indicate that the patient has received at least one of the following: advice to quit smoking or tobacco use, counseling on the benefits of quitting, assistance with or referral to external smoking or tobacco cessation support programs, or is currently enrolled in a smoking or tobacco use cessation program.

1. What is HCPCS G9458?

HCPCS code G9458 is a specific code used in medical coding to identify patients who are tobacco users and have received tobacco cessation intervention. It is important for healthcare providers to accurately document this information to ensure proper coding and billing.

2. Official Description

The official description of HCPCS code G9458 is “Patient documented as tobacco user and received tobacco cessation intervention (must include at least one of the following: advice given to quit smoking or tobacco use, counseling on the benefits of quitting smoking or tobacco use, assistance with or referral to external smoking or tobacco cessation support programs, or current enrollment in smoking or tobacco use cessation program) if identified as a tobacco user.” The short description is “Tob user recd cess interv.”

3. Procedure

  1. The healthcare provider identifies the patient as a tobacco user through patient history or other means of assessment.
  2. The provider provides the necessary tobacco cessation intervention, which may include advice to quit smoking or tobacco use, counseling on the benefits of quitting, assistance with or referral to external smoking or tobacco cessation support programs, or enrollment in a smoking or tobacco use cessation program.
  3. The provider documents the patient’s tobacco user status and the specific tobacco cessation intervention provided.

4. When to use HCPCS code G9458

HCPCS code G9458 should be used when a patient is identified as a tobacco user and has received tobacco cessation intervention. It is important to note that the intervention must include at least one of the following: advice given to quit smoking or tobacco use, counseling on the benefits of quitting smoking or tobacco use, assistance with or referral to external smoking or tobacco cessation support programs, or current enrollment in a smoking or tobacco use cessation program.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G9458, healthcare providers need to document the patient’s tobacco user status and the specific tobacco cessation intervention provided. This documentation should include details such as the date of the intervention, the type of intervention provided, and any relevant supporting information. It is important to ensure accurate and complete documentation to support the billing of this code.

6. Historical Information and Code Maintenance

HCPCS code G9458 was added to the Healthcare Common Procedure Coding System on January 01, 2015. As of the effective date, there have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code.

7. Medicare and Insurance Coverage

The coverage of HCPCS code G9458 may vary depending on the payer. Medicare considers this code to be covered under carrier judgment (coverage code C). It is important to check with individual insurance providers to determine their specific coverage policies for this code.

8. Examples

Here are five examples of when HCPCS code G9458 should be billed:

  1. A patient is identified as a tobacco user during a routine check-up. The healthcare provider provides counseling on the benefits of quitting smoking and documents the intervention.
  2. A patient is enrolled in a smoking cessation program and receives assistance with quitting smoking. The provider documents the enrollment and assistance provided.
  3. A patient visits a healthcare facility and expresses a desire to quit smoking. The provider gives advice on quitting smoking and documents the intervention.
  4. A patient is referred to an external smoking cessation support program by their healthcare provider. The provider documents the referral and assistance provided.
  5. A patient is currently enrolled in a tobacco use cessation program and receives ongoing counseling. The provider documents the enrollment and counseling sessions.

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