Alcoholism and substance abuse are big risks to the adolescent population, and pediatricians clearly recognize the need to counsel against, screen for, and intervene against use and abuse as shown in the American Academy of Pediatrics policy statement, “Substance Use Screening, Brief Intervention, and Referral to Treatment for Pediatricians” ( From a coding and payment perspective, counseling, anticipatory guidance, and risk factor reduction, including those related to alcohol and drug abuse, are inclusive components of a preventive service. But when screening and intervention are indicated at an encounter other than a preventive medicine examination, other codes and payment guidelines will apply.

Current Procedural Terminology contains codes for services that include use of a structured screening instrument with brief intervention. These codes are

Though the code descriptors include examples of AUDIT and DAST screening tools, a validated questionnaire designed for adolescents would also meet the structured screening criteria. For...

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