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* 1. Currently, CPT codes 99406 (smoking and tobacco cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes) or code 99407 (smoking and tobacco cessation counseling visit; intensive, greater than 10 minutes) may be used when you are counseling a child or adolescent about smoking cessation. According to CPT, these codes are not to be reported on your patient when the parent or guardian is counseled on smoking cessation or tobacco use.

One way to obtain payment when the parent or guardian smokes and is being counseled by the pediatrician (since carriers do not regard parents/guardians as patients of the pediatrician) is to report the E/M service (e.g., 99201-99215) using time as the key factor.

Another way would be a code that specifically allows counseling of parent/caregiver when billed under the child (similar to physician vaccine counseling is usually to the parent/caretaker, even though it's the child who is receiving the vaccines.)

If such a code existed, would you use it?

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* 2. Do you/does your practice currently use 99406-7 codes?

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* 3. Does it make more sense to use a single code for patient and parent smoking cessation, or to create separate codes?

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* 4. For nonpediatrician stakeholders who might not "get it" as far as the importance of passive smoke exposure and the pediatrician's role in counseling parents, what talking points/data would you suggest to get this code created and then paid for?

e.g. -If you can get parents to quit, the child is less likely to start as a youth.
-Parents may not have a medical home themselves, but the conversation is easy to start when I'm seeing a child for recurrent OM/wheezing/etc.

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* 5. Other thoughts on a parent/guardian smoking counseling code (feel free to free associate)

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