ICD-10-CM vaping coding guidance

Insurance coverage and payment for claims often depends as much on the diagnosis codes as the procedure codes reported. And as researchers continue to investigate vaping devices in a search for the cause of vaping-related lung injuries, the Centers for Disease Control and Prevention (CDC) has provided supplemental diagnosis coding information that may help you submit claims for services provided to patients with such injuries.

Specifically, in conjunction with the Oct. 1 annual update to the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), the CDC has made available a supplement to the ICD-10-CM guidelines for coding encounters related to e-cigarette, or vaping, product use. The supplement offers guidance on how to code patients with the following:

• Documented e-cigarette, or vaping, product use associated lung injury. Assign a code for the specific condition, such as J68.0, Bronchitis and pneumonitis due to chemicals, gases, fumes and vapors, includes chemical pneumonitis; J69.1, Pneumonitis due to inhalation of oils and essences, includes lipoid pneumonia; J80, Acute respiratory distress syndrome; J82, Pulmonary eosinophilia, not elsewhere classified; J84.114, Acute interstitial pneumonitis; J84.89, Other specified interstitial pulmonary disease.
  
  
• Acute lung injury but without further documentation identifying a specific condition. Assign code J68.9, Unspecified respiratory condition due to chemicals, gases, fumes, and vapors.
  
  
• Acute nicotine exposure and/or acute tetrahydrocannabinol toxicity. Assign code T65.291-, Toxic effect of other nicotine and tobacco, accidental (unintentional), includes toxic effect of other tobacco and nicotine NOS, or assign code T40.7X1-, Poisoning by cannabis (derivatives), accidental (unintentional).

The supplement also discusses diagnosis coding for related substance use, abuse, and dependence and provides guidance on coding patients presenting with any signs or symptoms (such as fever) where a definitive diagnosis has not been established.

Visit the Centers for Medicare & Medicaid Services’ 2020 ICD-10-CM webpage for more information on the 2020 edition of ICD-10-CM.

— Kent Moore, Senior Strategist for Physician Payment at the American Academy of Family Physicians