Skip to main content

Alcohol Misuse Screening and Counseling CPT G0442 and G0443


  • G0442 – Annual alcohol misuse screening, 15 minutes
  • G0443 – Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes

Who Is Covered

All Medicare beneficiaries are eligible for alcohol screening.

Medicare beneficiaries who screen positive (those who misuse alcohol but whose levels or patterns of alcohol consumption do not meet criteria for alcohol dependence) are eligible for counseling if,
  • They are competent and alert at the time counseling is provided and
  • Counseling is furnished by qualified primary care physicians or other primary care practitioners in a primary care setting

Covered ICD Codes

  • F10.282 Alcohol dependence with alcohol-induced sleep disorder
  • F10.288 Alcohol dependence with other alcohol-induced disorder
  • F10.29 Alcohol dependence with unspecified alcohol-induced disorder
  • F10.920 Alcohol use, unspecified with intoxication, uncomplicated
  • F10.921 Alcohol use, unspecified with intoxication delirium
  • F10.929 Alcohol use, unspecified with intoxication, unspecified
  • F10.94 Alcohol use, unspecified with alcohol-induced mood disorder
  • F10.950 Alcohol use, unspecified with alcohol-induced psychotic disorder with delusions
  • F10.951 Alcohol use, unspecified with alcohol-induced psychotic disorder with hallucinations
  • F10.959 Alcohol use, unspecified with alcohol-induced psychotic disorder, unspecified
  • F10.96 Alcohol use, unspecified with alcohol-induced persisting amnestic disorder
  • F10.97 Alcohol use, unspecified with alcohol-induced persisting dementia
  • F10.980 Alcohol use, unspecified with alcohol-induced anxiety disorder
  • F10.981 Alcohol use, unspecified with alcohol-induced sexual dysfunction
  • F10.982 Alcohol use, unspecified with alcohol-induced sleep disorder
  • F10.988 Alcohol use, unspecified with other alcohol-induced disorder
  • F10.99 Alcohol use, unspecified with unspecified alcohol-induced disorder
  • F12.23 Cannabis dependence with withdrawal
  • F12.93 Cannabis use, unspecified with withdrawal
  • O99.310 Alcohol use complicating pregnancy, unspecified trimester
  • O99.311 Alcohol use complicating pregnancy, first trimester
  • O99.312 Alcohol use complicating pregnancy, second trimester
  • O99.313 Alcohol use complicating pregnancy, third trimester
  • O99.314 Alcohol use complicating childbirth
  • O99.315 Alcohol use complicating the puerperium
  • R45.88 Nonsuicidal self-harm
  • T51.8X2A Toxic effect of other alcohols, intentional self-harm, initial encounter
  • T51.8X3A Toxic effect of other alcohols, assault, initial encounter
  • T51.8X4A Toxic effect of other alcohols, undetermined, initial encounter
  • T51.92XA Toxic effect of unspecified alcohol, intentional self-harm, initial encounter
  • T51.93XA Toxic effect of unspecified alcohol, assault, initial encounter
  • T51.94XA Toxic effect of unspecified alcohol, undetermined, initial encounter
  • Z02.83 Encounter for blood-alcohol and blood-drug test
  • Z13.30 Encounter for screening examination for mental health and behavioral disorders, unspecified
  • Z13.31 Encounter for screening for depression
  • Z13.32 Encounter for screening for maternal depression
  • Z13.39 Encounter for screening examination for other mental health and behavioral disorders
  • Z63.72 Alcoholism and drug addiction in family
  • Z71.41 Alcohol abuse counseling and surveillance of alcoholic
  • Z71.42 Counseling for family member of alcoholic
  • Z71.84 Encounter for health counseling related to travel
  • Z81.1 Family history of alcohol abuse and dependence


  • Annually for G0442
  • For those who screen positive, 4 times per year for G0443

Medicare Beneficiary Pays

  • Copayment/coinsurance waived
  • Deductible waived

Popular posts from this blog

Usage of CPT Index - Instructions

The alphabetic index is not a substitute for the main text of the CPT codebook. Even if only one code is present, the coder must refer to the main term to ensure that the code is selected accurately and correctly to identify the services rendered. Main Terms The index is organized by main terms. Each main term can stand alone or can be followed by up to three modifying terms. There are four primary classes of main entries, Procedures or Services - E.g, Scopic, Anastomosis, Splint, Opening Organ or Other Anatomical Site - E.g, Knee, Arm, Ear, Tibia, Colon Conditions - E.g, Abscess, Entropion, Tetralogy of Fallot. Synonyms, Eponyms, and Abbreviations. - ECG, EEG, PET, Brock Operations, Clagett Procdures Modifying Terms The main term may be followed by up to three indented terms that modify the terms they follow. EG. The main term "Endoscopy" is subdivided by the anatomical sites in which the procedure is used. And within these anatomical sites, the specific purpose of the pr

Additional Information About Modifiers

Sequencing of modifiers  How can that be if the modifiers used were accurate?  There is an order to reporting modifiers and there are three categories that modifier usage fall under:  1. Pricing  Pricing modifiers are always sequenced “before” payment modifiers and/or location modifiers.   The only exception to this rule is when a global surgery package is involved.  For example, you would code modifier 58 first and modifier 82 second in a global surgery.  A few examples of pricing modifiers are: 22, 26, 50, 52, 53, 62, 80, and P1-P6.   2. Payment   Payment modifiers alert the insurance carrier that there is a special situation within the claim  Some examples of payment modifiers would be: 24, 25, 51, 57, 58, 59, 76, and 78.  3. Location  Examples of location modifiers are: E1-E4, FA, F1-F9, LC, LD, LT, RT, RC, TA, and T1-T9.  The general order of sequencing modifiers is ( 1) pricing (2) payment (3) location. Location modifiers, in all coding situations, are coded “last”.  If you code

Evaluation and Management (E/M) Services - Domiciliary or Rest Home Environment

Domiciliary, Rest Home, or Custodial Care Services CPT codes 99324 - 99337 Domiciliary, Rest Home (e.g. Boarding Home), or Custodial Care Services, are used to report E/M services to individuals residing in a facility which provides room, board, and other personal assistance services, generally on a long-term basis.  These codes are also used to report E/M services in an assisted living facility. The facility’s services do not include a medical component. A home or domiciliary visit includes a patient History, Physical Examination and Medical Decision Making in various levels depending upon a patient’s needs and diagnosis.  The visits may also be performed as counseling and/or coordination of car, when medically necessary outside the office environment and are an integral part of a continuous of the patient's care.  The patients seen may have chronic conditions, may be disabled, either physically or mentally, making access to a traditional office visit very difficult, or may have l