I am confused about when to use the "Z" codes for smoking and when to use the F17 codes. If they are a current smoker I have been using a code from F17. However lately I've been noticing that some practices are using the Z72.0. I cannot find any clear documentation that states which one is more appropriate. Can someone shed some light on this for me? Thanks!
It pretty much has to do with the status of the nicotine use (smoking).
Z72.0 is for Tobacco Use NOS. I'm pretty sure those using that code for an active smoker aren't looking in the index...
In the index, if you lookup "Smoker", it states "
See Dependence, drug, nicotine". You're directed to dependence, NOT use, meaning Z72.0 would not be correct based on the index directions.
Lookup Dependence (on) (syndrome)>drug NEC>nicotine>cigarettes sends you to F17.210
Depending on the documentation, other codes in F17.21- might apply instead (in remission, for example)
In your case, you are correct to code from F17.21-. If you're looking for documentation, just pull out your trusty I-10 book and follow the index. It's pretty straightforward.
I do want to make note of code Z77.22 Contact with and (suspected) exposure to environmental tobacco smoke (acute) (chronic). It can be used for "Passive smoking (acute) (chronic)" if a patient is a "social smoker" or similar. The good old "I only smoke when I drink" statement.
