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California Health & Wellness is no longer a Medi-Cal plan starting January 1, 2024. Regardless of the county you live in, your Medi-Cal service and benefits will not be impacted by the health plan changes since you will be assigned to a new health plan. The county you live in determines your new health plan. Learn more

19-028 Stop Tobacco Use to Reduce Emergency Room Visits

Date: 01/11/19

Providers can help members quit tobacco products with counseling, medication and referrals to support services

The annual increase in emergency room (ER) visits from smokers is 63 percent over that of non-smokers. In addition, pediatric ER visits due to asthma and ear infections are related to patients who reside in a household with smokers.1

Nearly 7 out of 10 U.S. adult tobacco users want to quit.2 Quitting often takes more than one attempt. With counseling, medications and continued support, the chances of quitting increase threefold, which can reduce ER visits.

Tobacco Cessation

California Health & Wellness Plan (CHWP) encourages providers to help their patients kick the tobacco habit through best practices and by connecting them to:

California Smokers’ Helpline

www.NOBUTTS.org/tobacco-users-medi-cal-members

1-800-NO-BUTTS or (1-800-662-8887)

California Smokers’ Helpline (CSH) services include –

  • 24/7 online help in English, Spanish, Cantonese, Mandarin, Korean, and Vietnamese.
  • No-cost telephone counseling, text, chat, mobile app, and educational materials.
  • Special services for pregnant smokers, teens, e-cigarette users, and tobacco chewers.
  • Free nicotine patches for qualified callers who are pregnant, have young children or speak Asian languages.
  • Proactive provider referral options available at www.nobutts.org/ helpline-referral-options.
  • Referral to local smoking cessation programs.

Provider Best Practices

Practices to help members quit using tobacco include:

  • Explain how tobacco affects health issues and offer counseling.
  • Refer tobacco users to CSH’s helpline at 1-800-N-BUTTS (1-800-662-8887) or www.nobutts.org.

1American Journal of Respiratory Cell and Molecular Biology (ajrccm) Issues > Vol. 135, No. 3 Mar 01, 1987.

2Centers for Disease Control and Prevention. Current Cigarette Smoking Among Adults–United States, 2005–2016. Morbidity and Mortality Weekly Report 2018;67(2):53-9 [accessed 2018 Feb 22].

  • Offer at least one face-to-face counseling session per quit attempt.
  • Provide education and print materials to prevent initiation of tobacco use, especially among school-aged children and adolescents.
  • For pregnant members, check the American College of Obstetrics and Gynecology (ACOG) tobacco cessation guidelines before prescribing tobacco cessation medications.

Provider Training and Continuing Medical Education

The following provider online resources and training reduce tobacco use. Continuing education (CE) and continuing medical education (CME) credits are also available.

Resources/Training

Description

Registration/Information

American Academy of Pediatrics (AAP)

Free clinician webinar series on child health issues related to tobacco control

www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/Richmond-Center/Pages/Training-and-CME-Courses.aspx

California Smokers’ Helpline (CSH)

Free live webinars, online CE/CME courses, materials (toolkits, fact sheets and more)

www.NOBUTTS.org/free-training

Council for Tobacco Treatment Training Programs (CTTP)

Trainings to become a certified tobacco treatment specialist

https://cttp.org

Global Tobacco Control

A no-cost online resource that provides trainings, research-based reports and guides

www.globaltobaccocontrol.org/content/
online-courses

Smoking Cessation Leadership Center (SCLC) at the University of California, San Francisco

Online, easy-to-use trainings; tobacco use and secondhand smoke education activities

https://smokingcessationleadership.ucsf.edu/
webinars/cme

Free CME/CEUs for all eligible California
providers: https://cmecalifornia.com/Activity/
6245474/Detail.aspx#lnk6245474

Tobacco Treatment Training

Web-based trainings about clinical tobacco interventions for treatment, prevention and cessation.

www.umassmed.edu/tobacco/training

Billing Codes for Tobacco Counseling Services

When counseling for tobacco use intervention during an office visit, use the following CPT codes:

CPT code

Description

Number of visits/duration

99406

Symptomatic, smoking and tobacco use cessation counseling visit

Greater than 3 minutes, up to 10 minutes each visit

99407

Symptomatic, smoking and tobacco use cessation counseling visit

Greater than 10 minutes

Use the following ICD-10 codes when recording tobacco use in the member’s medical record:

ICD-10 code

Nicotine dependence description

ICD-10 code

Nicotine dependence description

F17.200

Unspecified, uncomplicated

F17.221

Chewing tobacco, in remission

F17.201

Unspecified, in remission

F17.290

Other tobacco product, uncomplicated

F17.210

Cigarettes, uncomplicated

F17.291

Other tobacco product, in remission

F17.211

Cigarettes, in remission

Z87.891

Personal history of nicotine dependence

F17.220

Chewing tobacco, uncomplicated

 

 


Additional Information

Providers are encouraged to access CHWP’s provider portal online at www.cahealthwellness.com for real-time information, including eligibility verification, claims status, prior authorization status, plan summaries, and more.

If you have questions regarding the information contained in this update, contact your Provider Relations representative or call 1-877-658-0305.