# Cocaine use



## danastiff (Mar 1, 2012)

The patient is having a cesarean delivery and the DX is HELLP syndrome and also states cocaine use. Our question is what to use as the dx code for the cocaine use? One person in the office believes it is 648.33 and 304.2.  However, I'm not sure because I thought 648.3_ was for drug usage that was prescribed to the patient and not for drugs that they are using without a prescription. Can anyone please help us?


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## jmcpolin (Mar 1, 2012)

I am not seeing where 648.33 is for prescription drugs.


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## danastiff (Mar 1, 2012)

*re: cocaine abuse*

This is kind of where I am getting confused. The 648.3_ says it's applicable to conditions classifiable to 304. I looked up 304 and it states that it excludes nondependent abuse of drugs (305.1-305.9). I went to 305 and the note says 'includes cases where a person, for whom no other diagnosis is possible, has come under medical care because of the maladaptive effect of a drug on which he is not dependent and that he has taken on his own initiative to the detriment of his health or social functioning'. That made me think that 304 were for drugs that were prescribed to the patient and 305 were for those that were not. I may be totally wrong and am looking for a better explanation than I am finding in the ICD 9 book.


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## jmcpolin (Mar 1, 2012)

I think the difference between 304 and 305 is 304 is dependent so (addicted) and 305 (no mention of addiction).


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## Bready (Mar 1, 2012)

*cocaine abuse*

I am thinking it should be 648.43 and 304.2


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## danastiff (Mar 1, 2012)

*re: cocaine abuse*

Thank you both very, very much.


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