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CMS138v6 Code List

Code List: CMS138v6, 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.

This user-friendly code list is provided as a courtesy to our MicroMD users.  For more in-depth information about codes and/or criteria or to compare version changes, visit the CMS eCQI Resource Center at https://ecqi.healthit.gov/ (no user account required) or the United States Health Information Knowledgebase at https://ushik.ahrq.gov/mdr/portals (requires a free user account to view codes).

Item Codes
Encounter Codes
Encounter, Performed: Preventive Care Services – Group Counseling: CPT 99411, 99412
Encounter, Performed: Preventive Care Services – Other: CPT 99429
Encounter, Performed: Preventive Care Services – Initial Office Visit, 18 and Up: CPT 99385, 99386, 99387
Encounter, Performed: Preventive Care Services – Established Office Visit, 18 and Up: CPT 99395, 99396, 99397
Encounter, Performed: Preventive Care Services – Individual Counseling: CPT 99401, 99402, 99403, 99404
Encounter, Performed: Face-to-Face Interaction: SNOMED 12843005, 18170008, 185349003, 185463005, 185465003, 19681004, 207195004, 270427003, 270430005, 308335008, 390906007, 406547006, 439708006, 87790002, 90526000
Encounter, Performed: Annual Wellness Visit: HCPCS G0438, G0439
Encounter, Performed: Speech and Hearing Evaluation: CPT 92521, 92522, 92523, 92524, 92540, 92557, 92625
Encounter, Performed: Psych Visit – Diagnostic Evaluation: CPT 90791, 90792
Encounter, Performed: Health and Behavioral Assessment – Initial: CPT 96150
Encounter, Performed: Health and Behavioral Assessment , Reassessment: CPT 96151
Encounter, Performed: Health and Behavioral Assessment – Individual: CPT 96152
Encounter, Performed: Occupational Therapy Evaluation: CPT 97165, 97166, 97167, 97168
Encounter, Performed: Office Visit: CPT 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215
Encounter, Performed: Psych Visit – Psychotherapy: CPT 90832, 90834, 90837
Encounter, Performed: Psychoanalysis: CPT 90845
Encounter, Performed: Ophthalmological Services: CPT 92002, 92004, 92012, 92014
Encounter, Performed: Home Healthcare Services: CPT 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350
Counseling Codes
Intervention, Performed: Tobacco Use Cessation Counseling: CPT 99406, 99407
Intervention, Performed: Tobacco Use Cessation Counseling: SNOMED 171055003, 185795007, 185796008, 225323000, 225324006, 310429001, 315232003, 384742004, 395700008, 449841000124108, 449851000124105, 449861000124107, 449871000124100, 702388001, 710081004, 711028002
Medications
Medications: Tobacco Use Cessation Medications: Descriptions (RXNORM) 24 HR Bupropion Hydrochloride 450 MG Extended Release Oral Tablet (1232585); topiramate 50 MG Oral Tablet (151226); 12 HR Bupropion Hydrochloride 90 MG / Naltrexone hydrochloride 8 MG Extended Release Oral Tablet (1551468); Nicotine 0.5 MG/ACTUAT Metered Dose Nasal Spray (1797886); Smoking Cessation 12 HR Bupropion Hydrochloride 150 MG Extended Release Oral Tablet (1801289); 24 HR Nicotine 0.583 MG/HR Transdermal System (198029); 24 HR Nicotine 0.875 MG/HR Transdermal System (198030); 24 HR Nicotine 0.292 MG/HR Transdermal System (198031); Nortriptyline 10 MG Oral Capsule (198045); Nortriptyline 50 MG Oral Capsule (198046); Nortriptyline 75 MG Oral Capsule (198047); Nortriptyline 10 MG Oral Tablet (199283); topiramate 25 MG Oral Tablet (199888); topiramate 100 MG Oral Tablet (199889); topiramate 200 MG Oral Tablet (199890); topiramate 25 MG Oral Capsule (205315); topiramate 15 MG Oral Capsule (205316); Nicotine 4 MG/ACTUAT Inhalant Solution (250983); Nicotine 4 MG Chewing Gum (311975); Nortriptyline 2 MG/ML Oral Solution (312036); Nicotine 2 MG Chewing Gum (314119); Nortriptyline 25 MG Oral Capsule (317136); Nicotine 2 MG Oral Lozenge (359817); Nicotine 4 MG Oral Lozenge (359818); varenicline 0.5 MG Oral Tablet (636671); varenicline 1 MG Oral Tablet (636676); {11 (varenicline 0.5 MG Oral Tablet) / 42 (varenicline 1 MG Oral Tablet) } Pack (749289); {56 (varenicline 1 MG Oral Tablet) } Pack (749788); {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 (892244); 12 HR Bupropion Hydrochloride 100 MG Extended Release Oral Tablet (993503); 12 HR Bupropion Hydrochloride 150 MG Extended Release Oral Tablet (993518); 12 HR Bupropion Hydrochloride 200 MG Extended Release Oral Tablet (993536); 24 HR Bupropion Hydrochloride 150 MG Extended Release Oral Tablet (993541); 24 HR Bupropion hydrobromide 174 MG Extended Release Oral Tablet (993550); 24 HR Bupropion Hydrochloride 300 MG Extended Release Oral Tablet (993557); 24 HR Bupropion hydrobromide 348 MG Extended Release Oral Tablet (993567); 24 HR Bupropion hydrobromide 522 MG Extended Release Oral Tablet (993681); Bupropion Hydrochloride 100 MG Oral Tablet (993687); Bupropion Hydrochloride 75 MG Oral Tablet (993691); 168 HR Clonidine 0.00417 MG/HR Transdermal System (998671); 168 HR Clonidine 0.00833 MG/HR Transdermal System (998675); 168 HR Clonidine 0.0125 MG/HR Transdermal System (998679)
Smoking Status Codes
Tobacco Non-User Codes Aggressive ex-smoker (360900008)
Aggressive non-smoker (360918006)
Current non-smoker (160618006)
Current non-smoker but past smoking history unknown (405746006)
Does not use moist powdered tobacco (228501004)
Ex-cigar smoker (160621008)
Ex-cigarette smoker (281018007)
Ex-cigarette smoker amount unknown (266928006)
Ex-heavy cigarette smoker (20-39/day) (266924008)
Ex-light cigarette smoker (1-9/day) (266922007)
Ex-moderate cigarette smoker (10-19/day) (266923002)
Ex-pipe smoker (160620009)
Ex-smoker (8517006)
Ex-trivial cigarette smoker (<1/day) (266921000)
Ex-user of moist powdered tobacco (228503001)
Ex-very heavy cigarette smoker (40+/day) (266925009)
Intolerant ex-smoker (360890004)
Intolerant non-smoker (360929005)
Never chewed tobacco (228512004)
Never smoked tobacco (266919005)
Never used moist powdered tobacco (228502006)
Non-smoker (8392000)
Non-smoker for medical reasons (105541001)
Non-smoker for personal reasons (105539002)
Non-smoker for religious reasons (105540000)
Tolerant ex-smoker (53896009)
Tolerant non-smoker (87739003)
Tobacco User Codes Light cigarette smoker (1-9 cigs/day) (160603005)
Moderate cigarette smoker (10-19 cigs/day) (160604004)
Heavy cigarette smoker (20-39 cigs/day) (160605003)
Very heavy cigarette smoker (40+ cigs/day) (160606002)
Rolls own cigarettes (160619003)
Snuff user (228494002)
User of moist powdered tobacco (228504007)
Chews plug tobacco (228514003)
Chews twist tobacco (228515002)
Chews loose leaf tobacco (228516001)
Chews fine cut tobacco (228517005)
Chews products containing tobacco (228518000)
Occasional cigarette smoker (230059006)
Light cigarette smoker (230060001)
Moderate cigarette smoker (230062009)
Heavy cigarette smoker (230063004)
Very heavy cigarette smoker (230064005)
Chain smoker (230065006)
Trivial cigarette smoker (less than one cigarette/day) (266920004)
Occasional tobacco smoker (428041000124106)
Light tobacco smoker (428061000124105)
Heavy tobacco smoker (428071000124103)
Smokes tobacco daily (449868002)
Cigar smoker (59978006)
Cigarette smoker (65568007)
Smoker (77176002)
Chews tobacco (81703003)
Pipe smoker (82302008)
Screening Assessment Codes
Assessment, Performed: Tobacco Use Screening: LOINC 39240-7, 68535-4, 68536-2, 72166-2
Exception Reasons Screening Assessment Not Done
Medical Reasons for not performing assessment screening, counseling intervention, or providing cessation medications: Description (SNOMED code) Procedure contraindicated (183932001)
Treatment not indicated (183964008)
Drug treatment not indicated (183966005)
Failure in dosage (216952002)
Absent response to treatment (266721009)
Late effect of medical and surgical care complication (269191009)
Drug therapy discontinued (274512008)
Drug resistance (31438003)
Complication of medical care (35688006)
Treatment modification (371133007)
Medical contraindication (397745006)
Treatment not tolerated (407563006)
Not indicated (410534003)
Contraindicated (410536001)
Drug allergy (416098002)
Procedure discontinued (416406003)
Procedure not indicated (428119001)
Treatment changed (445528004)
Drug intolerance (59037007)
Adverse reaction caused by drug (62014003)
Drug interaction (79899007)
Exception Life Expectancy Diagnosis Codes
Documentation of Limited Life Expectancy: SNOMED 162607003, 162608008, 170969009, 27143004, 300936002

Last updated: May 14, 2018 12:29 PM