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Cessation-focused visits (CPT 99406/99407): For dedicated tobacco cessation counseling encounters, the principal diagnosis should be either the underlying condition the smoking is impacting (COPD, ischemic heart disease, etc.) or for outpatient counseling visits where no such condition is being addressed a Z-code such as Z71.6 (Tobacco abuse counseling) as the encounter reason, with F17.210 sequenced as a secondary diagnosis to specify the nicotine dependence

Cigar smokers are not inhaling the smoke

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At the same time, nicotine narrows blood vessels, which makes it even harder for oxygen-rich blood to reach the brain smoothly

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