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    v1.0.28
    OpenPayerBilling CodesPatient HistoryCPT cpt-1031f-asthma-tobacco-exposure-assessment-home
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    CPT 1031F: Asthma Tobacco Use and Home Secondhand Smoke Assessment

    CPT code 1031F documents that a provider interviewed the patient or their primary caregiver about the patient’s tobacco use and exposure to secondhand smoke in the home environment when the patient presented with a diagnosis of asthma; service type: counseling/behavioral assessment related to environmental tobacco exposure; typical site of service: outpatient clinic or office visit setting where asthma management and environmental exposure counseling are provided.

    For related coverage guidance, see recent payer policy updates: Prolonged Services for Labor Management, Prolonged Services for Labor Management, Cervical Cancer Screening.

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    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.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    99396Periodic comprehensive preventive medicine evaluation and management of an individual ... age 40-64 (example preventive visit)Preventive visit during which tobacco exposure screening and 1031F documentation may be completed.
    99213Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutesTypical problem-focused or expanded problem-focused visit in which tobacco exposure questions for asthma care are asked and 1031F documented.
    99406Smoking and tobacco use cessation counseling, intermediate, greater than 3 minutes up to 10 minutesProvided when brief counseling for tobacco cessation is delivered following a positive screen for household tobacco use.
    99395Periodic comprehensive preventive medicine evaluation and management of an individual ... age 18-39 (example preventive visit)Preventive visit setting for adults with asthma where 1031F may be documented.
    94640Pressurized or non-pressurized inhalation treatment for acute airway obstruction; administration of medication via metered dose inhaler with spacerAcute or routine asthma treatment that may occur in the same visit where environmental exposure screening is documented.

    Related Modifiers

    5 rows

    ModifierDescriptionWhen to Use
    95Modifier 95 indicates that a service was provided via synchronous, real‑time audio‑video telehealth rather than in‑person. Per CMS, AAPC and professional associations, append modifier 95 to claim…- Use modifier 95 to indicate a service was furnished via synchronous, real‑time audiovisual telehealth (a live audio‑video conference between patient and provider) rather than in‑person. - Pair…
    33Modifier 33 was created by the American Medical Association in response to the Affordable Care Act to identify services provided for preventive intent. It is appended to CPT/HCPCS codes that could be…- Use modifier -33 when a CPT/HCPCS service that can be billed as either preventive or diagnostic/treatment is provided with preventive intent and aligns with USPSTF A or B recommendations or other…
    27Modifier 27 indicates a separate, subsequent outpatient hospital E/M service provided to the same patient on the same date by a different provider in a hospital outpatient setting. It is a…- Use modifier -27 on facility (hospital outpatient/ambulatory service center) claims to report a subsequent, separate, and distinct outpatient E/M service provided to the same patient on the same…
    1PModifier 1P is a Category II performance measure exclusion modifier used to indicate that a patient’s medical condition prevented performance of the action specified by a Category II quality measure…- Use modifier 1P only with Category II (quality reporting) codes when the specific measure’s reporting instructions explicitly allow a medical-reason exclusion; it marks the patient as medically…
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    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207Q00000XFamily Medicine PhysicianFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadt…
    363A00000XPhysician AssistantA physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and…
    207K00000XAllergy & Immunology PhysicianAn allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Select…
    207R00000XInternal Medicine PhysicianA physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults…
    367A00000XAdvanced Practice MidwifeAdvanced practice midwifery encompasses the independent provision of care during pregnancy, childbirth, and the postpartum period; sexual and reproduc…
    163WX1500XOstomy Care Registered NurseNursing Service Providers · Registered Nurse
    284300000XSpecial HospitalA designation by the AHA of a hospital whose primary function of the institution is to provide diagnostic and treatment services for patients who have…
    224ZL0004XLow Vision Occupational Therapy AssistantOccupational therapy assistants contribute to the completion of an individualized occupational therapy low-vision evaluation under the direction and s…

    Related Payer Policy Updates

    Specialty: Obstetrics/Gynecology1 / 3

    8 rows

    PolicyPayerEffective Date
    Prolonged Services for Labor ManagementPremera Bluecross2027-01-01
    Prolonged Services for Labor ManagementPremera Bluecross2027-01-01
    Cervical Cancer ScreeningOscar Health2026-10-01
    Prenatal Testing for Fetal AneuploidyOscar Health2026-10-01
    Diagnosis of VaginitisOscar Health2026-10-01
    Prenatal Screening (Nongenetic)Oscar Health2026-10-01
    View PDF of Maternal Serum Biomarkers for Prediction of Adverse Obstetric Outcomes, Effective 10/1/2026 in MedicalBlue Cross Blue Shield - Rhode Island2026-10-01
    Maternal Serum Testing for Prediction of Adverse Obstetric OutcomesBluecross Idaho2026-09-01

    Related Codes

    CPT-1000F-CATEGORY-II-PERFORMANCE-MEASURE

    CPT 1000F: Tobacco Use Status Assessment

    CPT-1002F-NO-SUMMARY-AVAILABLE

    CPT 1002F: No Summary available

    CPT-1003F-PERFORMANCE-MEASURE

    CPT 1003F: Preventive Care Tobacco Use Counseling

    CPT-1004F-NO-SUMMARY-AVAILABLE

    CPT 1004F: Health Status Assessment

    CPT-1005F-NO-SUMMARY-AVAILABLE

    CPT 1005F: Peripheral Oxygen Saturation Assessment

    CPT-1006F-BRIEF-SUMMARY-NOT-AVAILABLE

    CPT 1006F: No Summary Available

    CPT-1007F-NO-SUMMARY-AVAILABLE

    CPT 1007F: Influenza Vaccination Administered

    CPT-1008F-UNSPECIFIED-SERVICE

    CPT 1008F: Depression Screening, Brief Standardized Assessment

    CPT-1010F-ANGINA-SEVERITY-ASSESSMENT-CAD-ACTIVITY-RESPONSE

    CPT 1010F: Angina Activity Assessment in Coronary Artery Disease

    CPT-1011F-THERAPEUTIC-MANAGEMENT-CORONARY-ARTERY-DISEASE-ANGINA

    CPT 1011F: Therapeutic Management for CAD with Angina

    Showing 1–10 of 81

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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