# Tobacco Exposure



## donsqueen (Dec 27, 2008)

How would you code tobacco exposure in a lifelong non-smoker? I can't believe with all the second hand smoke effects that there isn't a diagnosis code for this. I am thinking V15.89.

Thanks,

Amy


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## Cottrell (Dec 27, 2008)

I would use the new code V87.19- other hazardous aromatic chemicals-since polycyclic aromatic hydrocarbons are found in cigarette smoke.


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## kevbshields (Dec 27, 2008)

Well, what was described with this "tobacco exposure?"  Given the right diagnostic situation, wouldn't this qualify as a poisening?


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## MichelleRene (Dec 27, 2008)

Try E869.4.


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## Deanne N (Dec 28, 2008)

Is the pt having any symptoms? Is there a reason this is included in the record? Is it someone with a cough? Because, really, we ALL have exposure... if the pt has no symptoms, I think you should avoid the poisoning code, especially if the provider doesn't call it poisoning, and I wouldn't use an E code because those are causal; you could use a V code. 
You don't want to insert anything of yourself or your opinion in the record-- keep it clean.


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## Anna Weaver (Dec 29, 2008)

*second hand*

I took this through 3M and this is what I come up with:
994.9 effects of external causes and E869.4 accidental poisoning by second hand tobacco smoke. Anyone else?

I guess then you would have to determine if there were symptoms to cover this.


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## kevbshields (Dec 29, 2008)

That's why, again, we requested information on the diagnostic statement.  Enough information was not provided to make a determination.  I made a suggestion based on my "hunch" that there should be more in the record than what was provided to us.

Thanks.


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## Anna Weaver (Dec 29, 2008)

*tobacco exposure*

I would also agree with the V87.19 Other hazardous aromatic compounds, if it's just an exposure to second hand smoke with no symptoms to code.


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## donsqueen (Feb 23, 2010)

Wow, I had forgotten about this one and came back today to see if there was anything on this same topic. My current patient has COPD and a possible lung abscess due to years of working in a bar and being exposed to second hand smoke. 

Thank you all for your answers. I went with V87.39 contact/exposure to other substances. I'm just not comfortable with the aromatic chemicals without the doctor saying something about them.

Amy


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## dballard2004 (Feb 23, 2010)

You would report an E code.  Per AHA Coding Clinic, 4th quarter, 1994, pg.44 
E869.4, accidental poisoning by second-hand tobacco smoke is used to identify non-smokers exposed to "second-hand smoke". In order to assign E869.4, the physician must provide documentation that second-hand smoke or environmental tobacco smoke is the external cause. When there is NO condition or symptom, this code should not be assigned.


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## donsqueen (Feb 23, 2010)

Thank you Dawson!


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## dballard2004 (Feb 23, 2010)

You are very welcome!


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## scicchitanoa (Feb 23, 2010)

I would code:
994.9 Effect of external causes
E8694 Accidental poisoning by second-hand tobacco smoke


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## KellyLR (May 13, 2013)

*ICD10-CM Solves this*

I'm glad that ICD10-CM resolves this issue with a code to describe smoke exposure. Can't wait until we start with ICD10!!!!


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