Used for medical claim reporting in all healthcare settings, ICD-10-CM is a standardized classification system of diagnosis codes that represent conditions and diseases, related health problems, abnormal findings, signs and symptoms, injuries, external causes of injuries and diseases, and social circumstances.
Why ICD-10 codes are important
The ICD-10-CM (International Classification of Diseases, Tenth Revision, Clinical Modification) is a system used by physicians and other healthcare providers to classify and code all diagnoses, symptoms and procedures recorded in conjunction with hospital care in the United States.
The new codes are for describing the infusion of tixagevimab and cilgavimab monoclonal antibody (code XW023X7), and the infusion of other new technology monoclonal antibody (code XW023Y7).
ICD-10 code F12. 9 for Cannabis use, unspecified is a medical classification as listed by WHO under the range - Mental, Behavioral and Neurodevelopmental disorders .
Substance use, abuse, and dependence , for vaping of nicotine, assign code: ▪ F17. 29-, Nicotine dependence, other tobacco products. Electronic nicotine delivery systems (ENDS) are non-combustible tobacco products.
The condition came to be called “e-cigarette, or vaping, product use associated lung injury,” or EVALI. By February 2020, the CDC had recorded over 2800 hospitalizations due to EVALI along with 68 deaths caused by the condition.
The supplement offers guidance on how to code patients with the following: Documented e-cigarette, or vaping, product use associated lung injury. Assign a code for the specific condition, such as J68. 0, Bronchitis and pneumonitis due to chemicals, gases, fumes and vapors, includes chemical pneumonitis; J69.
For vaping of nicotine, assign code: F17. 29-Nicotine dependence, other tobacco products.
Personal history of nicotine dependenceICD-10 code Z87. 891 for Personal history of nicotine dependence is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .
Z72. 0 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
Vaping-associated pulmonary injury (VAPI), also called e-cigarette or vaping product use associated lung injury (EVALI), is an acute or subacute respiratory illness characterized by a spectrum of clinicopathologic findings mimicking various pulmonary diseases.
E-cigarettes produce a number of dangerous chemicals including acetaldehyde, acrolein, and formaldehyde. These aldehydes can cause lung disease, as well as cardiovascular (heart) disease. E-cigarettes also contain acrolein, a herbicide primarily used to kill weeds.
KMA Resource Guide.ICD-10 Coding for Tobacco Use/Abuse/Dependence.Category F17.21 is used to identify nicotine.dependence with cigarettes.Category F17.22 is used to identify nicotine.dependence with chewing tobacco.Category F17.29 is used to identify nicotine.dependence with other tobacco products.
Updates that are set to take effect October 1st, 2020 include: 490 new codes, 47 revised codes and 58 deleted or invalid codes.
A dab vape pen is used to vaporize a liquid form of cannabis, also known as concentrates, and U07.0 is the ICD-10 code for vaping marijuana. The CDC is investigating this outbreak of e-cigarette, or vaping, product use-associated lung injury (EVALI).
Previously, ICD-10-CM has not used Chapter 22, but it is being added so the code set is consistent with that of WHO. The new block of codes (U00-U85) are for special purposes, identified as “Provisional assignment of new diseases of uncertain etiology or emergency use” (U00- U49). There is also a note at the chapter level that Codes U00-U49 are to be used by WHO for the provisional assignment of new diseases of uncertain etiology.
Using an e-cigarette product is commonly referred to as “vaping.”.
Recently a breakthrough occurred that showed that Vitamin E acetate has been identified as a chemical of concern among people with e-cigarette, or vaping, product use-associated lung injury (EVALI).
M anifestation– What are the signs and symptoms indicative of a vaping-induced illness? These could be dyspnea, hemoptysis, pleuritic chest pain, other chest pain, hypoxemia, fever, leukocytosis, or others.
Researchers at the CDC suspect that reported cases of vaping-related illness are due to chemical exposure rather than infection; metals from the vaping coils can also be involved, as postulated in the NEJM article.
As of October 1, 2019, 1080 cases of respiratory illnesses and 18 deaths brought on by vaping have been reported in the U.S., according to the U.S. Centers for Disease Control and Prevention (CDC). Despite continued research into these cases by the CDC and the U.S. Food and Drug Administration ...
As part of an ongoing investigation, the FDA’s Center for Tobacco Products has collected more than 150 vaping product samples to test for chemicals, including painkillers, additives, pesticides, poisons, and toxins.
J69.1, pneumonitis due to inhalation of oils and essences (exogenous lipoid pneumonia. J84.89, other specified interstitial pulmonary diseases. J68.0, bronchitis and pneumonitis due to chemicals, gases, fumes and vapors. J68.1, pulmonary edema due to chemicals, gases, fumes and vapors.
Virgin Islands, and 18 people have died from vaping-related respiratory illness. Review their findings here.
Electronic cigarettes, more commonly referred to as e-cigarettes, are battery-powered devices that heat tetrahydrocannabinol (THC), nicotine, and other chemicals, and turn them into a vapor that can be inhaled. The use of an e-cigarette product is called vaping.
The purpose of this document is to provide official diagnosis coding guidance for healthcare encounters related to the 2019 health care encounters and deaths related to e-cigarette, or vaping, product use associated lung injury (EVALI). This guidance is consistent with current clinical knowledge about e-cigarette, or vaping, related disorders.
Acute nicotine exposure can be toxic. Children and adults have been poisoned by swallowing, breath ing, or absorbing e-cigarette liquid through their skin or eyes. For these patients assign code:
It also reveals that “new codes that are intended to address additional detail regarding use of e-cigarette, or vaping, products will be presented at the March 2020 ICD-10 Coordination and Maintenance Committee Meeting .” If the new codes are adopted, watch for changes to the vaping coding guidelines, as well.
If the medical record shows an acute lung injury, but does not provide a more specific condition like bronchitis, pneumonitis or the other examples in the code list above, then the supplement instructs you to use unspecified code J68.9 Unspecified respiratory condition due to chemicals, gases, fumes, and vapors.
Thousands of cases of e-cigarette, or vaping, product use associated lung injury (EVALI) have been reported from across the U.S. to the Centers for Disease Control and Prevention.
The supplement was approved by the four Cooperating Parties for ICD-10: the National Center for Health Statistics, the American Health Information Management Association, the American Hospital Association, and the Centers for Medicare and Medicaid Services.
EVALI is not the only reason you may see a patient in relation to e-cigarettes or vaping. Toxicity from acute nicotine exposure is another issue that physicians have encountered. For instance, patients may have swallowed or breathed in e-cigarette liquid. Absorption through the skin or eyes is also possible.
Effective with 4/1/2020 discharges, ICD-10-CM code U07.0 is used to report vaping -related disorders. ICD-10-CM code U07.0 (vaping related disorder) should be used when documentation supports that the patient has a lung-related disorder from vaping. This code is found in the new ICD-10-CM Chapter 22. U07.0 will be in listed in the ICD-10-CM manual under a new section: Provisional assignment of new disease of uncertain etiology or emergency use. When a person uses one of the electronic cigarettes/vape systems the device will heat up and vaporize a liquid to aerosol. The person would then “vape,” puff or inhale through the mouth the vaporized aerosol mist. Vaping is also documented as e-cigarette, vapes, e-hookahs, vape pens, tank systems, mods, and electronic nicotine delivery systems (ENDS) by some documenting physicians. Nicotine is not the only substance that is being inhaled. There are other chemicals in the liquid to help this turn to an aerosol. The electronic cigarettes can contain tetrahydrocannabinol (THC) and cannabinoid (CBD) oils along with other substances, flavorings and additives. Physicians may document “dabbing related lung damage,” vaping or any of the terms listed above to document the condition caused by the inhalation of nicotine or other substance as stated above. Below are some of the diagnoses that have been documented to be associated with patient’s vaping/use of e-cigarettes:
For vaping of nicotine, assign code: F17.29 -Nicotine dependence, other tobacco products.
Vaping Related Lung Disorders and Conditions: Bronchitis and pneumonitis due to chemicals, gases, fumes and vapors; includes chemical pneumonitis (J68.0) Pneumonitis due to inhalation of oils and essences; includes lipoid pneumonia (J69.1) When only acute lung injury is documented without specifying a specific condition, ...
There have been 68 confirmed deaths in the U.S. due to vaping-related lung injuries (as of 2/25/2020) There have been 2,807 patients hospitalized for vaping-related lung injury (as of 2/18/2020) More than 6 million American middle and high school students used some type of tobacco product last year.
Physicians may document “dabbing related lung damage,” vaping or any of the terms listed above to document the condition caused by the inhalation of nicotine or other substance as stated above. Below are some of the diagnoses that have been documented to be associated with patient’s vaping/use of e-cigarettes:
When only acute lung injury is documented without specifying a specific condition, code J68.9 —Unspecified respiratory condition due to chemicals, gases, fumes and vapors would be reported.
The aerosol/vapor that is produced in the e-cigarette is not a harmless water vapor. The aerosol/vapor can cause inflammations in the mouth. A smoker’s cough can be obtained via vaping. Most e-cigarettes contain nicotine. Even the ones that state are nicotine free have been found to have nicotine in them.
For children and adults who’ve been poisoned by swallowing, breathing, or absorbing e-cigarette liquid through their skin or eyes, assign code: 291- , Toxic effect of other nicotine and tobacco, accidental (unintentional); includes Toxic effect of other tobacco and nicotine NOS.
Vaping can become addictive because of the nicotine or other substance a user puts in it. It can also become habit-forming which can establish a dependence. For patients with documented substance use, abuse, and/or dependence, assign any additional codes that identify the substances.
The CDC is investigating the recent epidemic of vaping related injuries since the reporting of the first related death in August 2019. As of Oct. 29, 2019, 1,888 cases of EVALI have been reported and 37 related deaths have been confirmed. EVALI is a diagnosis of exclusion because it’s a relatively new condition without a definitive diagnostic test.
The aerosol inside of an e-cigarette that users inhale contains substances — such as nicotine, heavy metals, ultra-fine particles, and volatile organic compounds — that can cause harm, states the CDC. For patients documented with EVALI, you should assign specific codes related to specific conditions.
The liquid can contain nicotine, tetrahydrocannabinol (THC) and cannabinoid (CBD) oils, and additional substances and flavorings. Drinking the liquid can cause nicotine poisoning, but the liquid can also be inhaled or absorbed through the skin.
In a Coding Clinic example regarding a pediatric patient that was wheezing after exposure to e-cigarettes, the advice was to report the codes for wheezing and Z77.29, Contact with and (suspected) exposure to other hazardous substances . I do think that an adverse effect due to inhalation of vapors might be considered also.
Click to expand... Hi Christy, The CDC is currently investigating an outbreak of severe lung disease by those who currently or recently used an e-cigarette products. Yes, you would be correct in selecting a code from J68, however, there is an instructional note that indicates that you are to code first (T51-T65) to identify the cause.