tci ED Coding & Reimbursement Alert - 2008 Issue 9

You Be the Coder: Specific Questions Safeguard 99408 Claims

Question: I am looking at an encounter form in which the ED physician counseled a patient with commercial insurance about his drug use for 22 minutes. I am unsure if the session meets CPT parameters for 99408. How can I decide whether to report the counseling code? Utah Subscriber Answer: To get paid for 99408 (Alcohol and/or substance [other than tobacco] abuse structured screening [e.g., AUDIT, DAST], and brief intervention [SBI] services; 15 to 30 minutes) and 99409 (... greater than 30 minutes), the ED physician must document a structured screening session and an intervention if the screening...

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