# How do you now when to use code for "dependence" vs code for "use"



## Msjf83 (Mar 16, 2018)

*How do you now when to use code for "dependence" vs code for "use"*

In class we are trying to figure out when to use refinance vs use when it comes to coding for a cigarette smoker and neither is documented.
"Patient smokes cigarettes" is the wording 
Book says F10. Code for dependence but why not just use Z72.0?


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## mitchellde (Mar 16, 2018)

When we question doctors at a cancer research facility, they stated that "patient smokes" is tobacco use,
"Patient smokes 'X' packs per day" or "patient has a pack year habit of 'X' packs" is nicotine dependence.


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## dreamtwister (Jan 30, 2019)

*Tobacco use in pregnancy*

Here is my question.  Guidelines clearly state that if a woman is pregnant and uses tobacco we must code to the O99.33xcode for tobacco use  complicating pregnancy  there is the use additional code F17.  to identify type of tobacco nicotine dependence.  If patient smoke cigarettes,  the choices are F17.210-uncomplicated, F17.211 in remission, F17.213 with withdrawal, F17.218 - with other nicotine induced disorders, or F17.219  with unspecified nicotine induced disorders. I'm confused on which code is appropriate.  uncomplicated  well, no she is pregnant how can it be uncomplicated?  she actively smokes, in remission is out. hard to go through withdrawal if you are still smoking F17.213 is out that  only leaves the with other/unspecified nicotine use disorders  but I don't think the fact she is pregnant has been induced by the nicotine?????  Am I crazy?  I need HELP!!!


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