Choices expand from 305.1 to F17.2-- beginning Oct. 1, 2013.
When the family physician sees a patient who is nicotine dependent (to the detriment of the patient's health or social functioning), you have one diagnosis choice: 305.1 (Nondependent abuse of drugs; tobacco use disorder). Once ICD-10 goes into effect on Oct. 1, 2013, however, you'll modify your tobacco use disorder coding in several ways.
You'll start with code series F17.2 (Nicotine dependence). Because specificity is a key factor of ICD-10, check the physician's documentation for more details about the patient's situation.
- The fifth digit in the F17.2 series indicates the tobacco product ((0= unspecified; 1 = cigarettes; 2 = chewing tobacco; and 9 = other tobacco products)
- The sixth digit indicates status of the patient's dependence (0= uncomplicated; 1= in remission; 3=with withdrawal; 8= with other nicotine-induced disorders; 9= with unspecified nicotine-induced disorders).
Caution:
Several entries in the ICD-10 index have back-references to F17.200, including diagnoses that fall under "Dependence (on) (syndrome)" and "Tabacism, tabacosis, tabism/Poisoning, tobacco (meaning dependence [without remission])." Looking further at the code options, however, will show that F17.200 shouldn't be your automatic choice for these patients. F17.200 merely indicates that the patient is nicotine dependent; the physician likely documented a definitive smoking habit (such as "patient smokes X packs cigarettes per day"). When the physician's documentation specifies the type of tobacco product and status of dependence, you can better pinpoint the best diagnosis.
Don't forget:
If the physician provides smoking cessation counseling, you might also be able to report diagnosis Z71.6 (
Encounter for tobacco abuse counseling). List Z71.6 first, followed by the appropriate code from the F17.2 series.