Wiki Smoking - Pack per day

[dje10008]

When the provider states "patient is an active smoker with 1 pack per day" would you use Z72.0 or F17.210. He doesn't specify the type of tobacco but reference the word "pack." Isn't cigarattes smoking measure as pack per day (PPD)?

 

[nickelclaw]

I think it is up to the facility there is no guidance on PPD translating to automatic cigarettes. But is definitely an F code.
F17200 for NOS or e-cig, cigars, vaping F17290. If I were you I would ask for facility guidance on this or just code the NOS F17.200

 

[thomas7331]

I would code this as cigarettes - that is clearly what the provider is describing, and no other type of nicotine use is measured in packs per day. The facility where I last worked did this, and in fact our encoder was set up to direct references to a 'pack' in the documentation to the cigarette code under nicotine dependence.

 

[nickelclaw]

sorry I look at it as pack could also be cigarellos(black and mild cigars with tip) which would be a different code.
How are we to know pack definition when there are no default guideline to assume pack is F17.210?

 

[thomas7331]

sorry I look at it as pack could also be cigarellos(black and mild cigars with tip) which would be a different code.
How are we to know pack definition when there are no default guideline to assume pack is F17.210?

Yes, that's possible but it would be rare. If it was packs of something other than cigarettes, they'd likely say that. I don't think it would be incorrect to assign the unspecified code, but my own feeling is that if you asked any physician what they're referring to when they say 'packs' in their notes, they're going to tell you they're talking about cigarettes, which is why I would choose the code for cigarettes. But there are many things like this in documentation for which there aren't any guidelines, and in these situations coders or their employers just have to use their best judgement.