# Caffeine



## LTibbetts (Dec 30, 2009)

Here's one I haven't come across yet. I need a code for excessive caffeine intake. My 3M keeps taking me back to some sort of drug abuse, is that right? It seems a little severe for caffeine, you know?


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## mitchellde (Dec 30, 2009)

I know what you mean.  But also I do not feel that excessive is the same thing as abuse.  Was this the only documented dx?  Where I am going is was there some other symptom attributed to the caffien so you code an adverse effect or maybe a V69 for problems related to lifestyle something like that.  I would really hesitate on a drug abuse code.


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## mitchellde (Dec 30, 2009)

Aslo I looked up caffene and get poisoning by caffene is 969.71 with an E code E854.2 for accidental.. just another idea


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## Melody Irvine (Dec 30, 2009)

*Drugs and Chemicals*

Code 969.71 is for caffeine, it is just identifying the stimulant of caffeine.


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## LTibbetts (Dec 30, 2009)

mitchellde said:


> I know what you mean.  But also I do not feel that excessive is the same thing as abuse.  Was this the only documented dx?  Where I am going is was there some other symptom attributed to the caffien so you code an adverse effect or maybe a V69 for problems related to lifestyle something like that.  I would really hesitate on a drug abuse code.



Yes, the primary code was palpitations and/or racing heart and I struggled with the fact that it could be a sign & symptom but he numbered it as a #2 dx which made me feel that he wanted listed in addition to.


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## mitchellde (Dec 30, 2009)

But remember to code poisoning there needs to be an effect of the poisoning such as papitations then the 969.71 then the E code.  I guess we just need to know how it was documented.


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## mitchellde (Dec 30, 2009)

now that was funny I just grabbed the papitations put of the air.. so there you go then papitations first, 969.71 and the E854.2 and your set.


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## LTibbetts (Dec 30, 2009)

Melody Irvine said:


> Code 969.71 is for caffeine, it is just identifying the stimulant of caffeine.



Thanks. I just hate to use a code requiring an Ecode for caffeine because it just doesn't seem to be a poisening but technically, I guess it is all I have to go with. Thanks again!


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## mitchellde (Dec 30, 2009)

It is a bit of a misnomer but the 969.71 is actually the poison code the E code is indicating it was not intentional so is really important.  And poisoning is anything that does not follow prescribed dosage.  The other way to do this is as an adverse reaction but with the verbage "excessive intake" I feel we should not got to adverse effect since that would indicate a correct dosage taken correctly.


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## LTibbetts (Dec 30, 2009)

mitchellde said:


> now that was funny I just grabbed the papitations put of the air.. so there you go then papitations first, 969.71 and the E854.2 and your set.



Thanks, Deb. That is what I will go with. Unfortunately, I don't have a lot to work with on this one. We use t-sheets for our ER patients and this PA is one of the absolute worst ones her for documentation. He is definitely one of our biggest challenges here Under the clinical impression, he just circled palpitaions and then wrote the excessive caffeine under it (barely ledgible).


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## FTessaBartels (Jan 7, 2010)

*Definitely poisoning*

Leslie, I understand your hesitancy. As adults, we take our morning jolt of coffee for granted. But caffeine is a stimulant and can have adverse effects if taken in excess. Our ER has seen children coming in with heart palpitations due to drinking numerous "energy drinks" ... most of which contain caffeine.

If it helps ... remember that Tylenol taken in excess can lead to liver failure and death (yet most of us think nothing of popping of couple of them for minor aches).  

F Tessa Bartels, CPC, CEMC


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