Smoking cessation is a significant component of preventive healthcare, and primary care physicians are at the forefront of this battle. By providing structured support and using appropriate medical billing practices, physicians can significantly impact their patients’ journey to quit smoking while ensuring they are fairly compensated for their services.
In collaboration with our partners at DoctorCare, we have created a quick reference guide to streamline the use of smoking cessation codes. This guide aims to enhance patient care and ensure accurate billing. You can download the full guide here.
Effectively Managing Patients in their Smoking Cessation Journey
E079 – Initial Discussion with the Patient
The E079 code is designed for the initial discussion with patients who currently smoke. This service is rendered by the primary care physician most responsible for the patient’s ongoing care. The conversation should include asking the patient about their smoking status, their plans to quit, and setting a potential quit date. The E079 code is an add-on code and can be billed alongside various other codes including Q001, A003, A007, K013 and more. The fee value is $15.55 for in-person or video consultations and $13.20 for phone consultations, with a limit of once per 365 days.
K039 – Follow-Up Visit
The K039 code is used for follow-up visits dedicated to discussing smoking cessation. The fee value is $33.45 and can be billed twice in the 12 months following the initial E079 consultation. The follow-up visits are not time-based and should focus solely on smoking cessation, ensuring continuous support for the patient’s efforts to quit smoking.
Q042 – Counselling Fee
Q042 is an incentive paid alongside the K039 for rostered patients under various payment models, such as FHO, FHG, FHN, and CCM. The fee value is $7.50 per session with a limit of two times per year.
Best Practices for Implementing Smoking Cessation Support
To ensure your patients receive the best possible support in their smoking cessation efforts, consider the best practices:
- Engage Regularly: Frequent, structured interactions increase the likelihood of successful smoking cessation. Use the smoking cessation codes appropriately and ensure that follow-up visits are scheduled and conducted regularly.
- Document Thoroughly: Accurate documentation of each visit and the patient’s progress is essential. This includes completing the smoking cessation flow sheet and using the correct billing codes.
- Educate and Motivate: Provide patients with educational materials and motivational support to help them understand the benefits of quitting smoking and stay committed to their goals.
Practical Tips for Effective Management in OSCAR Pro
Tickler Tool for Patient Recalls
Manage patient recalls effectively by creating a tickler after the appointment. Set a date for your staff to book follow-up appointments. Watch the Tickler Tool video for detailed instructions.
Generate Reports for Smoking Cessation Recall Patients
Generate reports by registering patients with the ICD-9 code in the Disease Registry of the eChart. Create a custom report template to pull up a list of these patients at any time, facilitating timely follow-ups. Download our quick reference guide here to learn how.
Flow Sheet and Measurement Group Creation
Creating a flow sheet or measurement group in your EMR can help track the smoking cessation process. Download our quick reference guide here to learn how.
Create a Super Code
To simplify billing, you can create a Super Code including K039 and Q042. Download our quick reference guide here to learn how.
Common Medical Billing Errors and Solutions
Physicians may encounter some billing errors when billing for smoking cessation. Here are a few common errors and how to resolve them:
| Error Code | How to Resolve |
| M1 – Max Fee Allowed for These Services Has Been Reached | This error occurs when the annual limit for smoking cessation codes is exceeded. Ensure you track the number of times these codes are billed to avoid this issue. |
| A36 – Claimed by Other Practitioner | This error happens when another practitioner has already billed the smoking cessation fee for the patient. Coordination within your practice is key to preventing overlapping claims. |
| PAA – No Initial Fee Previously Paid | This error arises when K039/Q042 is billed without an E079 within the last 365 days. Ensure the initial E079 is billed before submitting follow-up codes. |
| DF – Corresponding Fee Code Not Claimed or Was Approved at Zero | This error occurs when E079 or K039 is billed with an incompatible code. Verify the codes before submission to avoid this issue. |
Physicians play a significant role in supporting patients through their smoking cessation journey. By following up with their patients and effectively using the tools in OSCAR Pro, healthcare providers can offer structured and continuous support to their patients while effectively getting paid for the services they provide.