Wiki Smoker in ICD-10-CM

donnajrichmond

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If I look in the index of ICD-10-CM under "Smoker" it directs me to "Dependence, drug, nicotine". Looking that up directs me to F17.
There is an Exclude 1 at F17 for "tobacco use NOS (Z72.0).

If the record indicates 3 pack a day smoker - do you code F17.x or Z72.0?
 
if the record indicates 3 packs per day then that is a habit or dependence and gets the F17 if however the record indicates the patients smokes without indicating the habit then it would be the Z72.0.
 
What about if they document the length of time the pt has been a smoker vs the number of packs per day? For instance: pt has smoked for the last 30 years.

THanks
Peggy
 
Let me provide my input for this.

If documentation states "Smoker" then you are going to be using the proper F code as this will give you a dependence code. I know there is an article from the AAPC out there that also states that if they call it "passive smoker" you would use Z72.0

Now, there was an issue with this in my facility, because a lot of the times, the provider will say "patient smokes 3 packs per day"
I mean yes, that is definitely dependence, but then again, there is no "Dependence" or "smoker" documentation, and there is an article by AHIMA that states, for you to use the F code, you do need to have proper "Dependence" documentatino from the provider, and they refer you to Chapter 5 guidelines for this.

So for your case yes, smoker will give you dependence. Just becareful for other cases.

Hope this helps!
 
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