- 305.1 (Tobacco use disorder)
- V15.82 (History of tobacco use)
- 649.0x (Tobacco use disorder complicating pregnancy, childbirth or the puerperium)
- E869.4 (Accidental poisoning by second-hand tobacco smoke)
However in ICD-10-CM, we will have the opportunity to explore the many different ways that tobacco smoke can affect a patient’s health status. Consider ICD-10-CM code F17.2xxx (Nicotine dependence). The expansion to the seventh digit increases the code specificity by identifying the type of tobacco product (e.g., cigarettes versus chewing tobacco) as well the nature of the dependence (e.g., uncomplicated, in remission, with withdrawal, or other nicotine induced disorders).
Note the following ICD-10-CM codes:
- Z72.0 (Problems related to lifestyle, tobacco use NOS)
- Z58.7 (Problems related to physical environment, exposure to environmental tobacco smoke [acute] [chronic])
These codes are classified like an ICD-9-CM V-code as a status influencing health status and will likely be assigned for cases in which the physician does not document nicotine dependence but maybe something like “social smoking” and for the latter just merely second-hand smoke exposure (not resulting in a poisoning).
The following two codes are similar in format to the ICD-9-CM codes for these diagnoses:
- Z87.82 (Personal history of nicotine dependence)
- O99.33x (Smoking [tobacco] complicating pregnancy, childbirth and the puerperium)
The expansion of poisoning code T65.2xxx (Toxic effect of tobacco and nicotine) identifies the type of tobacco (cigarettes versus chewing tobacco) as well as the intent of the exposure (accidental, intentional, assault, or undetermined), representing a nice combination of our current poisoning codes and E codes into a single code.
In ICD-9-CM, there currently are no specific codes for the newborn to identify exposure or definitive conditions directly caused by the mother’s use of tobacco during the perinatal period. But consider the following ICD-10-CM codes:
- P96.81 (Exposure to [parental][(environmental] tobacco smoke in the perinatal period)
- P04.2 (Newborn [suspected to be] affected by maternal use of tobacco)
In ICD-9-CM, there are essentially four different ways to identify tobacco use or other such related conditions. In ICD-10-CM, that number doubles. ICD-10-CM will give us the opportunity to report with greater specificity for tobacco use and exposure, but it is only one of many coding scenarios. Stay tuned for more examples of this as I continue to explore ICD-10-CM.