Reporting the Health Effects of Vaping Now and in April 2020

December 19th, 2019 - Wyn Staheli, Director of Research
Categories:   Diagnosis Coding   Allergy|Immunology   Cardiology|Vascular   Emergency Medicine   Home Health|Hospice   Internal Medicine   Interventional Radiology   Oncology|Hematology   Primary Care|Family Care   Pulmonology  
0 Votes - Sign in to vote or comment.

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.

E-cigarette / Vaping Associated Lung Injury (EVALI)

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
  • J80, Acute respiratory distress syndrome
  • J82, Pulmonary eosinophilia, not elsewhere classified
  • J84.114, Acute interstitial pneumonitis
  • 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:

  • M79.10 Myalgia, unspecified site
  • R06.00 Dyspnea, unspecified
  • R06.02 Shortness of breath
  • R06.2 Wheezing
  • R06.82 Tachypnea, not elsewhere classified
  • R07.9 Chest pain, unspecified
  • R09.02 Hypoxemia
  • R09.89 Other specified symptoms and signs involving the circulatory and respiratory systems (includes chest congestion)
  • R10.84 Generalized abdominal pain
  • R10.9 Unspecified abdominal pain
  • R11.10 Vomiting, unspecified
  • R11.11 Vomiting without nausea
  • R11.2 Nausea with vomiting, unspecified
  • R19.7 Diarrhea, unspecified
  • R50.- Fever of other and unknown origin
  • R53.83 Other fatigue
  • R61 Generalized hyperhidrosis (night sweats)
  • R63.4 Abnormal weight loss
  • R68.83 Chills (without fever)

###

Questions, comments?

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.


Latest articles:  (any category)

To Our Codapedia Friends!
July 30th, 2020 - Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
Codapedia friends, come and join us at Find-A-Code - a core product of innoviHealth! The information found on Codapedia comes from our sister company, Find-A-Code. If you do not already have a subscription with the greatest online coding encyclopedia, call us and get signed up today. We are offering a ...
OIG Report Highlights Need to Understand Guidelines
July 28th, 2020 - Wyn Staheli, Director of Research
A new OIG report once again highlights the necessity for organizations to fully understand requirements for reporting services and having proper documentation. The types of problems addressed in this report are ongoing issues for multiple types of services and specialties and for many different payers.
Office of Inspector General Says Medicare Advantage Organizations are Denying Services Inappropriately
July 21st, 2020 - Aimee Wilcox
We attended the recent virtual RISE National Conference and had the opportunity to listen to presenters share their knowledge about risk adjustment and HCC reporting and data validation. Among the presenters were representatives from the Office of Inspector General (OIG), who presented findings from encounter data from 2012-2016. They began ...
Use the Correct Diagnosis Codes and Revenue Codes to Get Paid for PAD Rehab
July 15th, 2020 - Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
The initial treatment in rehabilitation for patients suffering from Intermittent Claudication (IC) is Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD).  Rehabilitation using SET involves the use of intermittent walking exercise, which alternates periods of walking to moderate-to-maximum claudication, with rest.   When reporting 93668 for peripheral arterial disease rehabilitation the following ...
New Name Same Great Product! "HCC Plus"
July 14th, 2020 - Find-A-Code
Hello HCC Customers! We have made a change in name only to our HCC subscription. The new subscription is now called “HCC Plus”. Keep in mind there have been no changes to the product. Using your subscription along with the risk adjustment calculator will ensure you stay current with...
Are NCCI Edits Just for Medicare?
July 14th, 2020 - Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
The National Correct Coding Initiative (NCCI) edits were developed by CMS to help promote proper coding and control improper coding that leads to incorrect payments with part B claims. It is important to understand that NCCI edits do not include every possible code combination or every type of un-bundling combination. With that ...
Payment Adjustment Rules for Multiple Procedures and CCI Edits
July 9th, 2020 - Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
Surgical and medical services often include work that is required to be done prior to a procedure and post-procedure. When there are multiple procedures done by the same physician, group, or another qualified healthcare professional on the same day, the pre and post work is only required once. Therefore, CMS ...



Home About Contact Terms Privacy

innoviHealth® - 62 E 300 North, Spanish Fork, UT 84660 - Phone 801-770-4203 (9-5 Mountain)

Copyright © 2000-2020 innoviHealth Systems®, Inc. - CPT® copyright American Medical Association