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Tobacco Exposure

  1. Default Tobacco Exposure
    Medical Coding Books
    How would you code tobacco exposure in a lifelong non-smoker? I can't believe with all the second hand smoke effects that there isn't a diagnosis code for this. I am thinking V15.89.



  2. #2
    north seattle wa
    I would use the new code V87.19- other hazardous aromatic chemicals-since polycyclic aromatic hydrocarbons are found in cigarette smoke.

  3. #3
    Louisville, KY
    Well, what was described with this "tobacco exposure?" Given the right diagnostic situation, wouldn't this qualify as a poisening?

  4. #4
    Try E869.4.

  5. #5
    Portland Metro
    Is the pt having any symptoms? Is there a reason this is included in the record? Is it someone with a cough? Because, really, we ALL have exposure... if the pt has no symptoms, I think you should avoid the poisoning code, especially if the provider doesn't call it poisoning, and I wouldn't use an E code because those are causal; you could use a V code.
    You don't want to insert anything of yourself or your opinion in the record-- keep it clean.

  6. #6
    Default second hand
    I took this through 3M and this is what I come up with:
    994.9 effects of external causes and E869.4 accidental poisoning by second hand tobacco smoke. Anyone else?

    I guess then you would have to determine if there were symptoms to cover this.

  7. #7
    Louisville, KY
    That's why, again, we requested information on the diagnostic statement. Enough information was not provided to make a determination. I made a suggestion based on my "hunch" that there should be more in the record than what was provided to us.


  8. #8
    Default tobacco exposure
    I would also agree with the V87.19 Other hazardous aromatic compounds, if it's just an exposure to second hand smoke with no symptoms to code.

  9. Default
    Wow, I had forgotten about this one and came back today to see if there was anything on this same topic. My current patient has COPD and a possible lung abscess due to years of working in a bar and being exposed to second hand smoke.

    Thank you all for your answers. I went with V87.39 contact/exposure to other substances. I'm just not comfortable with the aromatic chemicals without the doctor saying something about them.


  10. #10
    Overland Park, KS
    You would report an E code. Per AHA Coding Clinic, 4th quarter, 1994, pg.44
    E869.4, accidental poisoning by second-hand tobacco smoke is used to identify non-smokers exposed to "second-hand smoke". In order to assign E869.4, the physician must provide documentation that second-hand smoke or environmental tobacco smoke is the external cause. When there is NO condition or symptom, this code should not be assigned.
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P, CRHC, AAPC Fellow

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