K039 – Smoking Cessation Follow-up Visit
OHIP Consultation & Visit Premium Codes Code — Family Practice & Practice in General (00) · Schedule of Benefits
Smoking cessation follow-up visit is the service rendered by a primary care physician in the 12 months following E079 that is dedicated to a discussion of tobacco smoking cessation, in accordance with the guidelines and subject to the conditions below.
When to Use
- Use K039 for a dedicated follow-up visit to review progress, troubleshoot nicotine replacement therapy, or address relapse within 12 months of a successful E079 claim.
- Use this code when the primary focus of the encounter is smoking cessation counseling, distinct from a standard A007 or A001 assessment.
Common Pitfalls
- Billing K039 without a preceding, paid E079 claim by the same physician within the previous 12 months will result in an automatic rejection.
- Exceeding the maximum limit of two K039 services per 12-month period following an E079 will trigger a rejection for the third claim.
- Billing K039 on the same day as K680 is prohibited, as these services are mutually exclusive.
Billing Tips
- Ensure your documentation explicitly references the '5A's' model (Ask, Advise, Assess, Assist, Arrange) to satisfy the CTI program requirements during an audit.
- If you provide a standard office visit (A007) on the same day as K039, ensure the smoking cessation discussion is distinct and documented separately to justify the additional service.
Effective: April 1, 2026
Consultations and Visits
Family Practice & Practice in General (00)
Assessment
Assessments, Psychotherapy, Psychiatric and Counselling Services
The medical record for this service must document that a follow-up visit regarding smoking cessation has taken place, by either completion of a flow sheet or other documentation consistent with the most current guidelines of the “Clinical Tobacco Intervention” (CTI) program, or the service is not eligible for payment.
Payment rules: 1. K039 is only eligible for payment when E079 is payable to the same physician in the preceding <docLink>12 month period</docLink>. 2. K039 is limited to a maximum of two services in the 12 months following E079.
Medical record requirements: The medical record for this service must document that a follow-up visit regarding smoking cessation has taken place, by either completion of a flow sheet or other documentation consistent with the most current guidelines of the “Clinical Tobacco Intervention” (CTI) program, or the service is not eligible for payment.
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