Coding Tobacco use
There is a way for coding tobacco use without stating that a patient has a mental condition. The condition has to cause a problem in the individual?s life usually to receive a mental health diagnosis.
There are certain points to be taken into consideration like:
? Why did the doctor document that the patient smoked/used tobacco? Was it the underlying cause of a medical condition, such as erectile dysfunction?
? Did it impact a medical condition, such as decreasing cilia movement in a patient with a respiratory problem?
? Did it decrease oxygenation and therefore slow the healing of a wound?
? Was it a risk factor for lung cancer and the doctor took time to help the patient understand the risks of his behavior? Why was this factor which influenced health a mental health issue?
In ICD-10-CM, there needs to be documentation as to why the tobacco use was entered into the record before applying a tobacco related code. For instance: If the patient has a dependency on tobacco, tobacco use is a health risk factor which does not impact this episode of care.
Examples:
? Patient presents to a physician with a desire to stop smoking and looks for assistance. The patient does not have any smoking associated issues or problems. Patient does not have any negative impacts in his family or work life due to smoking. Patient wants to avoid possible future health issues. Patient uses cigarettes and sometimes uses e-cigarettes. Patient has no other drug dependence or mental health issues.
The ICD10 ode for this case would be: Nicotine dependence, unspecified, uncomplicated F172.00
? Patient presents for laceration to right wrist caused by a sharp edge on the microwave door. Laceration is three days old. There is no sign of infection. Patient smokes 2 packs of cigarettes per day.
The ICD-10 code for this is Tobacco use Z72.0
Last Note: When there is a documentation of tobacco use, the documentation must be reviewed properly to ensure the correct use of tobacco or dependence code must be used. There are more than 60 other tobacco related codes including:
? Smoking (tobacco) complicating pregnancy O9933
? Newborn affected by maternal use of tobacco P042
? Exposure to (parental) (environmental) tobacco smoke in the perinatal period P9681
? Toxic effect of tobacco T652-
? Occupational exposure to environmental tobacco smoke Z5731
? Tobacco abuse counseling Z716
? Tobacco use Z720
? Contact with and (suspected) exposure to environmental tobacco smoke (acute) (chronic) Z7722
? Family history of tobacco abuse and dependence Z812