HCPCS code G9903: Patient screened for tobacco use and identified as a tobacco non-user

Be informed of the documentation and billing requirements to properly use and bill HCPCS code G9903 with our short guide.

Use Code

## **What is HCPCS code G9903?** HCPCS code G9903, "Patient screened for tobacco use and identified as a tobacco non-user," is a code used in the healthcare industry, particularly for quality reporting and tracking. It is a part of the G9902-G9908 code range for tobacco screening. The primary purpose of this code is to document that a patient was screened for tobacco use during a medical visit and was identified as a non-user. This is often done as part of routine health assessments, wellness check-ups, or when a patient's tobacco use status could impact their medical decisions or treatment plans. The screening can be a simple verbal question or a brief questionnaire. This code is commonly used in programs like the Merit-based Incentive Payment System (MIPS) as part of quality measures. For example, it is a component of Quality ID #226: "Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention."

## **HCPCS code G9903 documentation requirements** To properly use HCPCS code G9903, the medical record must clearly support the following: - **Screening**: Documentation must show that the patient was screened for tobacco use. This could be a note in the chart stating "Patient asked about tobacco use" or a completed screening form. Note the method and date of screening as well. - **Non-user status**: The documentation must explicitly state that the patient was identified as a tobacco non-user. - **Encounter**: The code must be tied to a specific patient encounter, such as a routine office visit or a wellness exam.

## **G9903 billing requirements** HCPCS code G9903 is primarily a performance measure code and is often used for quality reporting rather than for direct reimbursement. It is not typically a covered service under the Medicare Part B Physician Fee Schedule (PFS) but is used for MIPS quality reporting. - **Usage**: It is generally submitted with a minimum of once per performance period for MIPS-eligible clinicians for each applicable patient encounter. - **Bundling**: It may be reported in conjunction with an Evaluation and Management (E/M) code (e.g., a standard office visit code like 99213). Some payers may have specific policies regarding bundling these codes, so it's essential to verify with each payer. - **Payer policies**: While some payers may have specific billing guidelines for these codes, for many, they are used for data collection and quality reporting purposes. It's crucial for healthcare providers and billing staff to check with third-party payers for their specific coding, coverage, and payment policies.

## **Other relevant codes** - **G9902**: Patient screened for tobacco use and identified as a tobacco user. - **G9904**: Documented medical reason for not performing tobacco use screening. - **G9905**: Patient not screened, reason not given. - **G9906**: Tobacco user who received tobacco cessation intervention. - **G9908**: Tobacco user who did not receive cessation intervention, reason not given.

Frequently asked questions

No—G9903 is not covered under the Medicare Physician Fee Schedule. It’s used solely for quality reporting, such as MIPS, where it fulfills numerator criteria.

Use G9903 when a patient is screened and confirmed as a tobacco non-user. Use G9902 when screening identifies a tobacco user. Proper use ensures accurate quality data and adherence to reporting standards.

Yes. You must document that the screening occurred, the patient's status as non-user, screening method, and date—especially to support performance measurement and audits.