Wiki Dependency of drugs with different patterns of use

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jessv1910

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How would you code the following: Opioid Dependence Continuous, Cocaine Dependence Continuous and Cannabis Dependence Episodic? Would it be correct to report each drug separately - 304.01, 30421 and 30432 or would it be correct to report 304.71 (Dependency of Opioid and other drugs) and 304.32?
 
I think the second set is more accurate 304.71 and 304.32, since the opioid and cocaine is continuous, only cannabis is episodic, and we will get a combination code for opioid with any other drug continuous.

Any other suggestions please...

Thara L CPC H
 
Thara, I agree with you but what if I had mixed patterns of multiple drugs, for example: Opioid Dependence Continuous, Cocaine Dependence Continuous, Cannabis Dependence Episodic and Sedative Hypnotic Episodic. Would it be correct to code them all separate reporting 4 codes 304.01, 304.21, 304.32, and 304.12 and not using the combination codes 304.71 and 304.82? What do you think? I work in a Psychiatric Hospital and we do detox and rehab so I get a lot of these cases. Thank you for helping me! :)
 
Hi Jessica,

I suggest 304.71 because in the given scenario only opioid and cocaine have the same pattern of use (continuous) and the other drug pattern is episodic, so we cannot combine the episodic pattern and continuous pattern together, when all drug dependence pattern is same and the list includes an opioid we can use 304.71

see
304.7: Combinations of opioid type drug with any other
304.70 unspecified
304.71 continuous
304.72 episodic
304.73 in remission

For Cannabis Dependence Episodic and Sedative Hypnotic Episodic we can use 304.82

In short for multiple drugs in same pattern which includes opioid 304.71 and other 304.82.

Here is a coding clinic to support this

"Polydrug addict
Coding Clinic, March - April 1986 Page: 12

Question:

How is a polydrug addict coded?

Answer:

304.8 Combinations of drug dependence excluding opioid type drug, is used to classify known combinations as well as polydrug addict, not otherwise specified.

304.7 Combinations of opioid type drug with any other, is used when it is known that an opioid drug is one of the combinations."


Remember one thing: If your facility ask you to code all drugs separately you should code it in that way. It depends on the client guidelines also.

Hope it helps...

Thara L CPC H
 
Thara thank you! - The company auditing our charts suggested not to use both combination codes (304.7x and 304.8x) together. However the coding clinic does not really say anything about coding both combination codes 304.7X and 304.8X during the same hospitalization. I have been trying to find one but I only came across the one you sent me. Thank you for taking the time to answer me! It always help to know what other coders think! :)
 
also look at your 5th digit codes coding clinic 2nd qtr 1991 page 11 that should also help :)
 
Thanks Jessica...that coding clinic for 5th digit was helpful...

Thara L CPC H
 
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