Wiki Coding use of e-cigarettes

[dvance4210]

I was looking for some other posts about E-cigarettes and how to code but didn't see anything. The patient stopped smoking cigarette in 2015 (Z87.891) but is currently using e-cigarettes. Any advice??

 

[daedolos]

I'm guessing it would depend on what's being put into the e-cig device. It could be anything from F12-F19.

Peace
@_*

 

[SPatterson951]

I agree knowing what was in it and how often they use it makes all the difference. If they are using the "vape liquid" depending on the brand, have varied amounts of nicotine in it still. So technically there is probably still a dependence of nicotine. This does sound like a pretty good reason for ama to visit this and make some more distinctions in the guidelines or something.... what does everyone else think? I never really thought about this

 

[daedolos]

I agree knowing what was in it and how often they use it makes all the difference. If they are using the "vape liquid" depending on the brand, have varied amounts of nicotine in it still. So technically there is probably still a dependence of nicotine. This does sound like a pretty good reason for ama to visit this and make some more distinctions in the guidelines or something.... what does everyone else think? I never really thought about this

It doesn't even have to be nicotine in the e-cig. They offer all manners of oils. I'm sure this section of the ICD-10 will expand in the coming years.

Peace
@_*

 

[erjones147]

If oils, I guess we either have to code nothing OR toxic effect (if any) for whatever oil they are using OR maybe inhalant abuse/dependence??

 

[daedolos]

Anything burns if it's heated enough. Cannabis oils are current fashion but I'm sure there are other oils available not to mention other substances.

Peace
@_*

 

[stephanieannec]

Z72.0 is for use of tobacco. It does not matter which route, i.e., cigarettes vs cigar vs E-cig. Per coding guidelines, only use dependence codes (F17.-) when documentation explicitly indicates dependence.

If documentation states for example, "the patient has dependence on E-cigarettes" then the code would be F17.200 for nicotine dependence, unspecified, uncomplicated.

Of course, this is assuming that the e-cig "juice" is nicotine.

Now the funny thing is that there is no status code for use of cannabis. It's a diagnosis code (F12.90) so you have to make sure that the diagnosis of cannabis use is well documented before you code out.

 

[cubbiecatz]

Z72.0 is for use of tobacco. It does not matter which route, i.e., cigarettes vs cigar vs E-cig. Per coding guidelines, only use dependence codes (F17.-) when documentation explicitly indicates dependence.

If documentation states for example, "the patient has dependence on E-cigarettes" then the code would be F17.200 for nicotine dependence, unspecified, uncomplicated.

Of course, this is assuming that the e-cig "juice" is nicotine.

Now the funny thing is that there is no status code for use of cannabis. It's a diagnosis code (F12.90) so you have to make sure that the diagnosis of cannabis use is well documented before you code out.

I suggest F17.29 category instead of unspecified.

 

[nyckimmie]

Z72.0 is for use of tobacco. It does not matter which route, i.e., cigarettes vs cigar vs E-cig. Per coding guidelines, only use dependence codes (F17.-) when documentation explicitly indicates dependence.

If documentation states for example, "the patient has dependence on E-cigarettes" then the code would be F17.200 for nicotine dependence, unspecified, uncomplicated.

Of course, this is assuming that the e-cig "juice" is nicotine.

Now the funny thing is that there is no status code for use of cannabis. It's a diagnosis code (F12.90) so you have to make sure that the diagnosis of cannabis use is well documented before you code out.

Hi, I agree with the fact that the route doesn't matter but at my facility our Quality/Advisory/Education Committee gives this advice in 2023. "If documentation states tobacco abuse or use and no other detail, use Z72.0 tobacco use Nos because we do not know the mode of use. If it says cigarettes, chewing tobacco, cigar, vaping, etc., it's coded to dependence on that product since we always code to the highest level of specificity per the tabular tobacco used disorder is an inclusion term under (dependence F17.200)" Whether tobacco use or smoking is documented as occasional or social does not affect coding and should be reported when meeting criteria.” I feel like they are conflating the bolded portions. For ex. an occasional cigar would then be F17.200. Does anyone have more official advice or coding article to support that the route/tobacco product doesn't matter? Thank you.