More coding tips are being provided by the TrustHCS coding experts. In this blog entry we will review coding tobacco use, abuse, and dependence.
Follow the alphabetic index in the ICD-10-CM code book for appropriate code assignment using the main term “Tobacco”
- Tobacco, use code to Z72.0
- Dependence, tobacco directs the coder to – see Dependence, drug, nicotine
- Dependence, drug, nicotine codes to F17.200
- Subcategories under F17 identify specific tobacco products (chewing tobacco, cigarettes, specified product) and specific nicotine-induced disorder (uncomplicated, in remission, with withdrawal, with other nicotine-induced disorders, with unspecified nicotine-induced disorders). Of the F17 (Nicotine dependence) codes, only those specifying dependence “with withdrawal” are CCs, non are MCCs
- The term “smoker” in the ICD-10-CM alphabetic index, refers the coder to — see Dependence, drug, nicotine
- Code assignment for a patient who has a past history of tobacco dependence, not current dependence on tobacco, codes to Z87.891 (personal history of nicotine dependence)
- Electronic cigarettes are battery-powered vaporized devices that turn liquid nicotine into a vapor that can be inhaled
NOTE: Use the documentation provided in the medical record as well as the alphabetic index in the ICD-10-CM codebook to guide you to the appropriate code choice.
Helpful advice comes from the following Coding Clinics:
- Smoker (Tobacco Use versus Dependence) Coding Clinic, Fourth Quarter 2013 Page: 108
- Nicotine Dependence (Uncomplicated, in Remission and With Withdrawal) Coding Clinic, Fourth Quarter 2013 Page: 108
- Nicotine Dependence and Nicotine Induced Disorders Coding Clinic, Fourth Quarter 2013 Page: 109
For Example: The AHA Coding Clinic, 4th Quarter 2013, page 109, discusses the fact that the provider must document a cause and effect relationship between smoking and other disease processes before the coder may link the disease process to smoking.
- Example based on this coding clinic: Patient is a current cigarette smoker with a 20 year history of smoking who now presents with emphysema. The physician does not link the smoking to the emphysema in the medical record; therefore, it would not be appropriate for the coder to use F17.218, Nicotine dependence, cigarettes, with other nicotine-induced disorders.