Summary & Overview
CPT 1031F: Asthma Tobacco Use and Home Secondhand Smoke Assessment
CPT code 1031F represents documentation that a provider assessed and recorded tobacco use and household secondhand smoke exposure for a patient presenting with asthma. This measure captures a targeted counseling and assessment activity important for asthma management and preventive care, since tobacco exposure can worsen respiratory symptoms and affect treatment outcomes. Nationally, standardized documentation of tobacco exposure supports quality measurement, care coordination, and population health efforts for patients with respiratory disease.
Key payers included in coverage discussions are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code’s clinical context, typical service setting, and how the item is used in quality reporting and clinical workflows. The publication also outlines common modifiers and notes where additional data are not available in the input.
The report provides benchmarks and policy-relevant context where available, describes how the code fits into asthma care pathways, and highlights operational considerations for documentation and billing. It is written for national audiences including clinicians, billing professionals, and policy analysts seeking clear guidance on the role and meaning of CPT code 1031F in respiratory care quality measurement and documentation.
Billing Code Overview
CPT code 1031F documents that a provider interviewed a patient (or the patient’s primary caregiver) about tobacco use and exposure to secondhand smoke in the home when the patient presented with a diagnosis of asthma, and that the provider documented the findings.
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Service type: Counseling and documentation related to tobacco exposure assessment
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Typical site of service: Outpatient clinic or office setting where asthma care and caregiver interviews are conducted
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A parent brings a 7-year-old child with persistent asthma to a pediatric primary care clinic for a routine asthma follow-up. The clinic visit is performed in an outpatient office setting. The provider (pediatrician or nurse practitioner) reviews the child’s symptoms, medication adherence, and triggers. As part of the encounter, the clinician interviews the parent about tobacco use and exposure to secondhand smoke within the home environment, documents whether household members smoke, location of smoking (indoors/outdoors), frequency, and any recent changes. The clinician records counseling provided and the screening result in the medical record. This screening and documentation correspond to 1031F and are typically performed during an office visit for asthma management, preventive care visit, or a chronic care follow-up. Common workflow steps: review problem list and asthma control, ask standardized tobacco exposure questions, document findings in the chart, update the care plan and education, and coordinate referrals or resources if exposure is identified.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
Q6 | Service furnished under an approved school-based or school-linked program | Use when the tobacco exposure interview/documentation is performed as part of a qualifying school-based or school-linked program per payer rules. |