The World Health Organization (WHO) announced the emergency creation of a new ICD-10 code for vaping related disorders which became effective on September 29, 2019. However, the new code should not be used in the United States until April 1, 2020 at which time the new code (U07.0 “Vaping-related disorder”) should be used.
The emergency meeting of the WHO and other organizations took place in response to the reported increase of adverse health effects of vaping. This rare, mid-year addition of a new code enables health departments and government agencies to more accurately track the impact of vaping on health.
From October 1, 2019 until April 1, 2020, the following CDC coding guidelines (wording is all by the CDC) for reporting e-cigarette / vaping related disorders / conditions should be used. To enable stakeholders to better answer the question “what are the health risks of vaping”, healthcare providers should report the various health issues from vaping in the following manner.
J84.89, Other specified interstitial pulmonary disease
For patients with acute lung injury but without further documentation identifying a specific condition (pneumonitis, bronchitis), assign code:
J68.9, Unspecified respiratory condition due to chemicals, gases, fumes, and vapors
Poisoning and Toxicity Associated with E-cigarette / Vaping
Acute nicotine exposure can be toxic. Children and adults have been poisoned by swallowing, breathing, or absorbing e-cigarette liquid through their skin or eyes. For these patients assign code:
T65.291- Toxic effect of other nicotine and tobacco, accidental (unintentional); includes Toxic effect of other tobacco and nicotine NOS
For a patient with acute tetrahydrocannabinol (THC) toxicity, assign code:
T40.7X1- Poisoning by cannabis (derivatives), accidental (unintentional)
Substance Use, Abuse, and Dependence Associated with E-cigarette / Vaping
For patients with documented substance use/abuse/dependence, additional codes identifying the substance(s) used should be assigned.
When the provider documentation refers to use, abuse and dependence of the same substance (e.g. nicotine, cannabis, etc.), only one code should be assigned to identify the pattern of use based on the following hierarchy:
If both use and abuse are documented, assign only the code for abuse
If both abuse and dependence are documented, assign only the code for dependence
If use, abuse and dependence are all documented, assign only the code for dependence
If both use and dependence are documented, assign only the code for dependence.
Assign as many codes, as appropriate. Examples:
Cannabis related disorders: F12.---
Nicotine related disorders: F17.----
Specifically, for vaping of nicotine, assign code: F17.29-, Nicotine dependence, other tobacco products. Electronic nicotine delivery systems (ENDS) are non-combustible tobacco products.
Diagnosis Codes for Signs and Symptoms Associated with E-cigarette / Vaping
For patients presenting with any signs/symptoms (such as fever, etc.) and where a definitive diagnosis has not been established, assign the appropriate code(s) for each of the presenting signs and symptoms such as:
There are several considerations to be aware of before assigning a code for lesions and soft tissue excisions.
The code selection will be determined upon the following:
Check the pathology reports, if any, to confirm Morphology (whether the neoplasm is benign, in-situ, malignant, or uncertain)
Topography (anatomic location)
Type of closure required
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