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CMS138v5 Code List

Code List: CMS138v5, Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

MicroMD uses the following code lists to determine a patient’s inclusion in this measure.  To search for your code, simply press Ctrl + F on your keyboard, enter your code in the search field and press Enter on your keyboard.

ItemCodes
Encounter Codes
Encounter, Performed: Preventive Care Services – Group Counseling: CPT99411, 99412
Encounter, Performed: Preventive Care Services – Other: CPT99420, 99429
Encounter, Performed: Preventive Care Services – Initial Office Visit, 18 and Up: CPT99385, 99386, 99387
Encounter, Performed: Preventive Care Services – Established Office Visit, 18 and Up: CPT99395, 99396, 99397
Encounter, Performed: Preventive Care Services – Individual Counseling: CPT99401, 99402, 99403, 99404
Encounter, Performed: Face-to-Face Interaction: SNOMED12843005, 18170008, 185349003, 185463005, 185465003, 19681004, 207195004, 270427003, 270430005, 308335008, 390906007, 406547006, 439708006, 4525004, 87790002, 90526000
Encounter, Performed: Annual Wellness Visit: HCPCSG0438, G0439
Encounter, Performed: Speech and Hearing Evaluation: CPT92557, 92540, 92625, 92521, 92524, 92523, 92522
Encounter, Performed: Psych Visit – Diagnostic Evaluation: CPT90791, 90792
Encounter, Performed: Health and Behavioral Assessment – Initial: CPT96150
Encounter, Performed: Health and Behavioral Assessment , Reassessment: CPT96151
Encounter, Performed: Health & Behavioral Assessment – Individual: CPT96152
Encounter, Performed: Occupational Therapy Evaluation: CPT97003, 97004
Encounter, Performed: Office Visit: CPT99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215
Encounter, Performed: Psych Visit – Psychotherapy: CPT90832, 90834, 90837
Encounter, Performed: Psychoanalysis: CPT90845
Encounter, Performed: Ophthalmological Services: CPT92002, 92004, 92012, 92014
Encounter, Performed: Home Healthcare Services: CPT99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350
Counseling Codes
Intervention, Performed: Tobacco Use Cessation Counseling: CPT99406, 99407
Intervention, Performed: Tobacco Use Cessation Counseling: SNOMED171055003, 185792005, 185793000, 185794006, 185795007, 185796008, 225323000, 225324006, 310429001, 315232003, 384742004
Medications
Medications: Tobacco Use Cessation Pharmacotherapy: Descriptions (RXNORM){11 (varenicline 0.5 MG Oral Tablet) / 42 (varenicline 1 MG Oral Tablet) } Pack, {14 (24 HR Nicotine 0.292 MG/HR Transdermal System) / 14 (24 HR Nicotine 0.583 MG/HR Transdermal System) / 28 (24 HR Nicotine 0.875 MG/HR Transdermal System) } Pack, {56 (varenicline 1 MG Oral Tablet) } Pack, 12 HR Bupropion Hydrochloride 100 MG Extended Release Oral Tablet, 12 HR Bupropion Hydrochloride 150 MG Extended Release Oral Tablet, 12 HR Bupropion Hydrochloride 200 MG Extended Release Oral Tablet, 12 HR Bupropion Hydrochloride 90 MG / Naltrexone hydrochloride 8 MG Extended Release Oral Tablet, 168 HR Clonidine 0.00417 MG/HR Transdermal System, 168 HR Clonidine 0.00833 MG/HR Transdermal System, 168 HR Clonidine 0.0125 MG/HR Transdermal System, 24 HR Bupropion hydrobromide 174 MG Extended Release Oral Tablet, 24 HR Bupropion hydrobromide 348 MG Extended Release Oral Tablet, 24 HR Bupropion hydrobromide 522 MG Extended Release Oral Tablet, 24 HR Bupropion Hydrochloride 150 MG Extended Release Oral Tablet, 24 HR Bupropion Hydrochloride 300 MG Extended Release Oral Tablet, 24 HR Bupropion Hydrochloride 450 MG Extended Release Oral Tablet, 24 HR Nicotine 0.292 MG/HR Transdermal System, 24 HR Nicotine 0.583 MG/HR Transdermal System, 24 HR Nicotine 0.875 MG/HR Transdermal System, Nicotine 2 MG Chewing Gum, Nicotine 2 MG Oral Lozenge, Nicotine 4 MG Chewing Gum, Nicotine 4 MG Oral Lozenge, Nicotine 4 MG/ACTUAT Inhalant Solution, Nortriptyline 10 MG Oral Capsule, Nortriptyline 2 MG/ML Oral Solution, Nortriptyline 25 MG Oral Capsule, Nortriptyline 50 MG Oral Capsule, Nortriptyline 75 MG Oral Capsule, topiramate 100 MG Oral Tablet, topiramate 15 MG Oral Capsule, topiramate 200 MG Oral Tablet, topiramate 25 MG Oral Capsule, topiramate 25 MG Oral Tablet, topiramate 50 MG Oral Tablet, varenicline 0.5 MG Oral Tablet, varenicline 1 MG Oral Tablet
Smoking Status Codes
Patient Characteristic: Tobacco Non-User: SNOMED105539002, 105540000, 105541001, 160618006, 160620009, 160621008, 228501004, 228502006, 228503001, 228512004, 266919005, 266921000, 266922007, 266923002, 266924008, 266925009, 266928006, 281018007, 360890004, 360900008, 360918006, 360929005, 405746006, 53896009, 8392000, 8517006, 87739003
Non-smoker for personal reasons (finding), Non-smoker for religious reasons (finding), Non-smoker for medical reasons (finding), Current non-smoker (finding), Ex-pipe smoker (finding), Ex-cigar smoker (finding), Does not use moist powdered tobacco (finding), Never used moist powdered tobacco (finding), Ex-user of moist powdered tobacco (finding), Never chewed tobacco (finding), Never smoked tobacco (finding), Ex-trivial cigarette smoker (<1/day) (finding), Ex-light cigarette smoker (1-9/day) (finding), Ex-moderate cigarette smoker (10-19/day) (finding), Ex-heavy cigarette smoker (20-39/day) (finding), Ex-very heavy cigarette smoker (40+/day) (finding), Ex-cigarette smoker amount unknown (finding), Ex-cigarette smoker (finding), Intolerant ex-smoker (finding), Aggressive ex-smoker (finding), Aggressive non-smoker (finding), Intolerant non-smoker (finding), Current non smoker but past smoking history unknown (finding), Tolerant ex-smoker (finding), Non-smoker (finding), Ex-smoker (finding), Tolerant non-smoker (finding)
Patient Characteristic: Tobacco User: SNOMED160603005, 160604004, 160605003, 160606002, 160619003, 228494002, 228504007, 228514003, 228515002, 228516001, 228517005, 228518000, 230059006, 230060001, 230062009, 230063004, 230064005, 230065006, 266920004, 428041000124106, 428061000124105, 428071000124103, 449868002, 59978006, 65568007, 77176002, 81703003, 82302008
Light cigarette smoker (1-9 cigs/day) (finding), Moderate cigarette smoker (10-19 cigs/day) (finding), Heavy cigarette smoker (20-39 cigs/day) (finding), Very heavy cigarette smoker (40+ cigs/day) (finding), Rolls own cigarettes (finding), Snuff user (finding), User of moist powdered tobacco (finding), Chews plug tobacco (finding), Chews twist tobacco (finding), Chews loose leaf tobacco (finding), Chews fine cut tobacco (finding), Chews products containing tobacco (finding), Occasional cigarette smoker (finding), Light cigarette smoker (finding), Moderate cigarette smoker (finding), Heavy cigarette smoker (finding), Very heavy cigarette smoker (finding), Chain smoker (finding), Trivial cigarette smoker (less than one cigarette/day) (finding), Occasional tobacco smoker (finding), Light tobacco smoker (finding), Heavy tobacco smoker (finding), Smokes tobacco daily (finding), Cigar smoker (finding), Cigarette smoker (finding), Smoker (finding), Chews tobacco (finding), Pipe smoker (finding)
Risk Assessment Codes
Risk Category Assessment: Tobacco Use Screening: LOINC39240-7, 68535-4, 68536-2, 72166-2
Exception Reasons Risk Assessment Not Done
Risk Category Assessment not done: Medical Reason: SNOMED(31438003) Drug resistance
(35688006) Complication of medical care
(59037007) Drug intolerance
(62014003) Adverse reaction to drug
(79899007) Drug interaction
(183932001) Procedure contraindicated
(183964008) Treatment not indicated
(183966005) Drug treatment not indicated
(216952002) Failure in dosage
(266721009) Absent response to treatment
(269191009) Late effect of medical and surgical care complication
(274512008) Drug therapy discontinued
(371133007) Treatment modification
(397745006) Medical contraindication
(407563006) Treatment not tolerated
(410534003) Not indicated
(410536001) Contraindicated
(416098002) Drug allergy
(416406003) Procedure discontinued
(428119001) Procedure not indicated
(445528004) Treatment changed
Exception Life Expectancy Diagnosis Codes
Documentation of Limited Life Expectancy: SNOMED162607003, 162608008, 170969009, 27143004, 300936002