Wiki former smoker vs non smoker

sharonglaze

Contributor
Messages
13
Location
Dickinson, TX
Best answers
0
When can you consider a former smoker as a non smoker? My billing manager wants me to stop using Z87.891 after the pt has quit for 2 years. Not sure that this is correct.
 
Last edited:
I could not find any official coding guideline as to when using the history code should be stopped. I personally would only use it if it was relevant to the reason for visit, but the official guidelines state they are acceptable regardless.
From the ICD10-CM 2020 Guidelines, Chap 21, C), 4) 3rd paragraph "History codes are also acceptable on any medical record regardless of the reason for visit. A history of an illness, even if no longer present, is important information that may alter the type of treatment ordered."
In this link, it is advised on page 5, it is advised to use only if there is a clinical reason to code the former use.

So while the Official Guidelines state personal & family history codes are "acceptable", I could imagine someone spending an hour on each chart coding all the personal or family history of .... for items that are not your specialty, or have no relevance on your care for the patient. For example, my broken left ankle at age 8, or history of acne at 16, or a UTI 5 years ago, does not have any relevance whatsoever to a pulmonologist.

In your example, I would code it if the physician discussed how well they are doing with nicotine cravings, or discussed weight gain since smoking stopped, or ordered a chest xray.
 
I agree, a history of smoking should be coded when documented that it is relevant to the encounter - there is no rule that a former smoker becomes a non-smoker after a certain amount of time. A very remote history of smoking, or exposure to smoke, is often relevant and I have seen cases where patients have developed smoking-related disease later in life even after not smoking for many years.

I'd also just add that many diagnosis codes (e.g. hypertension, asthma, COPD, some cancers) have a 'code also' note that requires coders to also code the history of smoking when documented in the chart. To omit the history of smoking code in these cases, regardless of how many years had elapsed, would be considered incorrect coding and would be cited as a coding error if audited.
 
Our policy which we based on Optimum and Freedom guidelines is in remission for up to 10 years Personal history 10 years or more but we only worry about coding it if they have COPD neoplasm of lungs ect .
 
Top