October 24, 2024

Medical Coding Cannabis

By Janine Mothershed

Coding and Billing Guidelines for Cannabis in Healthcare 

As cannabis becomes increasingly legalized for medical use across various jurisdictions, the need for clear coding and billing guidelines has emerged. Understanding how to accurately document and bill for cannabis-related services is essential for healthcare providers, coders, and billing specialists to ensure compliance and proper reimbursement. 

Understanding Cannabis in Healthcare 

Cannabis can be used for a variety of medical conditions, including chronic pain, epilepsy, and nausea associated with chemotherapy. Due to its therapeutic potential, healthcare providers may recommend cannabis or related products, leading to the necessity for specific coding practices. 

Coding for Cannabis 

When it comes to coding for cannabis, it’s important to consider both the specific product being used and the medical necessity behind its use. Currently, there are no specific HCPCS codes solely for cannabis products. However, there are various codes that may be utilized, depending on the context: 

ICD-10 Diagnosis that supports cannabis use

These codes are used to document the patient’s medical condition that necessitates the use of cannabis. For example: 

Posttraumatic stress disorder

Anxiety 

Chronic pain 

Epilepsy 

Glaucoma 

Chemotherapy-induced nausea and vomiting 

AIDS 

Alzheimer’s disease 

Amyotrophic lateral sclerosis 

Cancer 

Crohn’s disease 

Depression 

Migraine  

Multiple sclerosis 

Tourette syndrome 

Inflammatory bowel disease 

Irritable bowel syndrome 

Multiple sclerosis and muscle spasms 

Parkinson’s disease 

Rapid heartbeat 

Schizophrenia 

Substance use disorder 

CPT Codes:

These codes may be applied to the services rendered, such as consultations, evaluations, or treatments involving cannabis. For instance: 

  1. 99203: New patient office visit, low complexity. 
  1. 99406: Smoking and tobacco use cessation counseling. 
  1. Drug Codes: If cannabis is being dispensed in a form that is classified as a drug, appropriate National Drug Codes (NDCs) may be used, particularly for CBD products or FDA-approved cannabis medications. 

ICD-10 Codes 

F12 Cannabis-related disorders  

 F12.1 Cannabis abuse  

 F12.10 …… uncomplicated  

 F12.11 …… in remission  

 F12.12 Cannabis abuse with intoxication  

 F12.120 …… uncomplicated  

F12.121 …… delirium  

 F12.122 …… with perceptual disturbance  

 F12.129 …… unspecified  

 F12.13 …… with withdrawal  

 F12.15 Cannabis abuse with psychotic disorder  

 F12.150 …… with delusions  

 F12.151 …… with hallucinations  

 F12.159 …… unspecified  

 F12.18 Cannabis abuse with other cannabis-induced disorder  

 F12.180 Cannabis abuse with cannabis-induced anxiety disorder  

F12.188 Cannabis abuse with other cannabis-induced disorder  

 F12.19 …… with unspecified cannabis-induced disorder  

 F12.2 Cannabis dependence  

 F12.20 …… uncomplicated  

 F12.21 …… in remission  

 F12.22 Cannabis dependence with intoxication  

 F12.220 …… uncomplicated  

 F12.221 …… delirium  

 F12.222 …… with perceptual disturbance  

 F12.229 …… unspecified  

F12.23 …… with withdrawal  

 F12.25 Cannabis dependence with psychotic disorder  

 F12.250 …… with delusions  

 F12.251 …… with hallucinations  

 F12.259 …… unspecified  

F12.28 Cannabis dependence with other cannabis-induced disorder  

 F12.280 Cannabis dependence with cannabis-induced anxiety disorder  

 F12.288 Cannabis dependence with other cannabis-induced disorder  

 F12.29 …… with unspecified cannabis-induced disorder  

 F12.9 Cannabis use, unspecified  

 F12.90 …… uncomplicated  

 F12.91 …… in remission  

 F12.92 Cannabis use, unspecified with intoxication  

 F12.920 …… uncomplicated  

 F12.921 …… delirium  

 F12.28 Cannabis dependence with other cannabis-induced disorder  

 F12.280 Cannabis dependence with cannabis-induced anxiety disorder  

 F12.288 Cannabis dependence with other cannabis-induced disorder  

 F12.29 …… with unspecified cannabis-induced disorder  

 F12.9 Cannabis use, unspecified  

 F12.90 …… uncomplicated  

 F12.91 …… in remission  

 F12.92 Cannabis use, unspecified with intoxication  

 F12.920 …… uncomplicated  

 F12.921 …… delirium  

 F12.922 …… with perceptual disturbance  

 F12.929 …… unspecified  

 F12.93 …… with withdrawal  

 F12.95 Cannabis use, unspecified with psychotic disorder  

 F12.950 …… with delusions  

 F12.951 …… with hallucinations  

F12.922 …… with perceptual disturbance  

 F12.929 …… unspecified  

 F12.93 …… with withdrawal  

 F12.95 Cannabis use, unspecified with psychotic disorder  

 F12.950 …… with delusions  

 F12.951 …… with hallucinations  

 F12.959 …… unspecified  

 F12.98 Cannabis use, unspecified with other cannabis-induced disorder  

 F12.980 Cannabis use, unspecified with anxiety disorder  

 F12.988 Cannabis use, unspecified with other cannabis-induced disorder  

F12.99 …… with unspecified cannabis-induced disorder 

Billing Guidelines 

Billing for cannabis-related services involves several considerations: 

  1. Medical Necessity: Documentation must clearly demonstrate the medical necessity for cannabis use. This includes patient evaluations, treatment plans, and progress notes. 
  1. Provider Type: Only licensed healthcare providers authorized to recommend cannabis should bill for related services. This may vary by state and jurisdiction. 
  1. Insurance Coverage: Coverage for cannabis varies widely among insurance providers. It is essential to verify each patient’s insurance policy regarding cannabis reimbursement before providing services. 
  1. Compliance with State Regulations: Providers must adhere to state regulations regarding the recommendation, dispensing, and billing of cannabis. This includes keeping accurate records and following the guidelines established by state medical boards. 
  2. Patient Consent: Informed consent from the patient should be obtained before recommending cannabis, and documentation should reflect this consent. 

As the landscape of cannabis in healthcare continues to evolve, understanding the coding and billing guidelines is critical for healthcare providers and billing specialists. Accurate documentation, adherence to coding practices, and compliance with state regulations will ensure proper reimbursement and enhance patient care. Ongoing education and training will be essential as regulations and practices surrounding cannabis use in healthcare develop. 

A use, abuse, and dependance bar chart

https://codingclarified.com/icd-10-coding-alcohol-use-abuse-and-dependence/

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