G9276 HCPCS: Reimbursement & Policy | OpenPayer

Summary & Overview

HCPCS G9276: Documentation of Current Tobacco Use

HCPCS Level II code G9276 denotes documentation that a patient is a current tobacco user. Capturing tobacco use status in the medical record supports clinical decision-making, preventive care workflows, population health management, and public health reporting. Nationally, consistent documentation of tobacco use helps align care coordination, tobacco cessation referrals, and quality measurement.

Key payers included in this overview are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. These payers commonly require accurate clinical documentation for risk adjustment, quality reporting, and care management programs.

Readers will learn what G9276 represents in clinical documentation, the primary service type and typical sites of service where the code is applied, and where to find related billing considerations. The publication provides benchmarks and policy-relevant context where available, notes common payer coverage patterns, and summarizes implications for clinical workflows and health record coding. Data not provided in the input—such as associated ICD-10 diagnoses, specific reimbursement rates, or payer-specific policy language—is noted as unavailable and is not fabricated.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareG9276HCPCS Level IItobacco useclinical documentationpreventive careambulatory carepopulation healthquality measurement

Billing Code Overview

HCPCS Level II code G9276 documents that a patient is a current tobacco user. This code represents the presence of tobacco use in the patient’s medical record and is used to capture clinical documentation of active tobacco consumption.

Service type: Documentation / Clinical Assessment

Typical site of service: Outpatient clinics, primary care offices, and other ambulatory care settings

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A primary care clinician documents that a patient is a current tobacco user during a routine outpatient visit. The patient is a 54-year-old presenting for chronic disease management (hypertension and hyperlipidemia). As part of the social history update and preventive counseling workflow, the nurse asks about tobacco use, records current cigarette smoking of 10 cigarettes per day, documents the start date, recent quit attempts, and readiness to quit. The clinician reviews the tobacco-use status, records it in the medical record, updates problem list and social history, and may provide brief counseling or referral to a tobacco-cessation program. The documentation that the patient is a current tobacco user is coded with G9276 to indicate the specific status for quality reporting and billing purposes. Typical site of service: outpatient primary care clinic or ambulatory care center. Service type: tobacco-use status documentation / social history update during an evaluation and management visit.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when additional documentation shows substantially greater effort or time beyond usual for the visit in which tobacco-use documentation occurred.

HCPCS G8854: Documentation of Non-Reportable Adherence to Evidence-Based Therapy

HCPCS-G8661-LOW-BACK-FUNCTIONAL-STATUS-NOT-MEASURED-PATIENT-NOT-APPROPRIATE

HCPCS G8661: Low Back Functional Status Not Measured, Patient Not Appropriate

HCPCS-G9630-NO-BOWEL-INJURY-POSTOPERATIVE-CONFIRMATION

HCPCS G9630: No Bowel Injury at Surgery or Within 30 Days

HCPCS-G8698-ANTITHROMBOTIC-THERAPY-NOT-PRESCRIBED-DISCHARGE

HCPCS Level II G8698: Antithrombotic Therapy Not Prescribed at Discharge

HCPCS-G9700-HOSPICE-USE-DURING-MEASUREMENT-PERIOD

HCPCS G9700: Hospice Use During Measurement Period

HCPCS-G0422-INTENSIVE-CARDIAC-REHABILITATION-SESSION

HCPCS G0422: Intensive Cardiac Rehabilitation Session

HCPCS-G2184-PATIENT-NO-CAREGIVER

HCPCS G2184: Patient Does Not Have a Caregiver

HCPCS-G9848-NO-SYSTEMIC-CANCER-THERAPY-LAST-14-DAYS-OF-LIFE

HCPCS G9848: No Systemic Cancer-Directed Therapy in Last 14 Days of Life

HCPCS-G9487-REMOTE-IN-HOME-EVALUATION-MANAGEMENT-ESTABLISHED-PATIENT

HCPCS G9487: Remote In-Home Evaluation and Management for Established Patients

HCPCS-G6006-RADIATION-SINGLE-PORTAL-20MEV-OR-GREATER

HCPCS G6006: Radiation Treatment Delivery, Single Area, ≥20 MeV

Showing 1–10 of 1996

23

Taxonomy Code	Specialty	Notes
207Q00000X	Family Medicine	Most common specialty documenting tobacco-use status in primary care.
207R00000X	Internal Medicine	Common in ambulatory chronic disease management visits where tobacco status is recorded.
363L00000X	Nurse Practitioner	NPs frequently document social history including tobacco use during clinic visits.
363A00000X	Physician Assistant	PAs commonly update and document tobacco-use status as part of visit workflow.
208D00000X	Pulmonology	Pulmonologists document tobacco use during respiratory disease evaluation and management.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Z72.0`	Tobacco use	Directly identifies current tobacco use and is commonly associated with documentation coded by `G9276`.
`F17.200`	Nicotine dependence, unspecified, uncomplicated	Relevant when dependence is present and may prompt cessation counseling after documentation of current use.
`Z87.891`	Personal history of nicotine dependence	Used when documenting past history; contrasts with current-use documentation `G9276`.
`J44.9`	Chronic obstructive pulmonary disease, unspecified	Tobacco use is a major risk factor and is clinically relevant when documenting current smoking status.
`I10`	Essential (primary) hypertension	Example of a chronic condition for which tobacco-use documentation is routinely updated during follow-up visits.
`E78.5`	Hyperlipidemia, unspecified	Another common comorbidity in primary care visits where tobacco-use status is documented.
`Z00.00`	Encounter for general adult medical examination without abnormal findings	Preventive visit context where tobacco-use status is typically recorded.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99406`	Smoking and tobacco-use cessation counseling intermediate, greater than 3 minutes up to 10 minutes	Often billed when brief tobacco cessation counseling is provided in the same visit after documenting current tobacco use.
`99407`	Smoking and tobacco-use cessation counseling intensive, greater than 10 minutes	Billed when more extensive cessation counseling is delivered following tobacco-use documentation.
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes	Common E/M visit during which tobacco-use status `G9276` is documented as part of the social history.
`99214`	Office or other outpatient visit for the evaluation and management of an established patient, typically 25 minutes	Used for higher-complexity visits where tobacco-use documentation is one element of the comprehensive encounter.
`99401`	Preventive medicine counseling, individual, approximately 15 minutes (historical; check payer-specific use)	May be used in preventive counseling workflows where tobacco-use status prompts focused prevention counseling.

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