I am hoping someone could help me with a question. If a patient used to be a smoker (cigarettes), and later developed COPD from the smoking, my understanding of the Guidelines would be that the COPD is a Sequela (since the patient is no longer a smoker), and the coding for the toxic effect would be T65.222S. Also, if a patient is a current smoker and developed COPD due to the smoking, this would be called an "effect" and not a "sequela" since the patient is a current smoker so the correct code for the Toxic Effect would be T65.222A (if treatment is first established or changed) or T65.222D (if treatment is just continued with no changes). I am using the "intentional self harm" since the patient smokes knowing that smoking is bad for them, but would that need to be stated by the provider, or can you infer it? Any resources that explains this in more detail would be helpful. Thanks so much!