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.
For patients documented with electronic cigarette (e-cigarette), or vaping, product use associated lung injury (EVALI), assign the code for the specific condition, such as:
J68.0, Bronchitis and pneumonitis due to chemicals, gases, fumes and vapors; includes chemical pneumonitis
J69.1, Pneumonitis due to inhalation of oils and essences; includes lipoid pneumonia
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:
If you have questions or comments about this article please contact us. Comments that provide additional related information may be added here by our Editors.
When x-rays are audited on the same date as an E/M encounter we have one of three decisions to make about the work that went into the radiological exam when the practice owns x-ray equipment and does their own interpretations internally. First, we must determine whether the x-ray was...
However, is the coding for the treatment and management of diabetes being adequately captured? Diabetes mellitus (DM) affects over 400 million people worldwide. It is a chronic disease of inadequate control of blood levels of glucose that affects the body’s ability to turn food into energy. Essentially, the...
In 2021, two major ESRD programs became effective, essentially preparing to transform not only risk adjusted services, but also at-home dialysis, health equity among beneficiaries needing transplant services, and improved access to donor kidneys.
Reporting IV infusion services can be complicated, especially when multiple infusions are reported in a single encounter. Take a few minutes to freshen up your knowledge on IV hydration coding with a review of the guidelines and a few coding scenarios.
Overlapping extrapolations require providers to pay twice. Some Medicare auditors have been caught “double-dipping,” the practice of sampling and extrapolating against the same set of claims. This is like getting two traffic tickets for a single instance of running a red light. This seedy practice doubles the amount...
Although HIPAA Security protocols have been in effect for some time, as technology advances, if we are not diligent, gaps can be left available for intruders. On top of that, on February 23, 2022, the American Hospital Association issued a cybersecurity advisory. They stated, “there is concern that Russia may retaliate against the U.S. and allied nations with disruptive cyberattacks.”
It’s important to remember that Medicare manuals are not binding, and they can’t “require” anything, including signatures. Regulatory framework is constantly changing. Never assume you know all of the rules, even if you carefully study them all the time. New things are constantly appearing....
