• When should you code for marijuana use?

    You may be seeing more patients who report marijuana use as part of their social history but who have no related complaints. A reader recently asked if a code should be assigned for this. The answer, according to FPM contributing editor Cindy Hughes, CPC, CFPC, is no.

    “The ICD-10 guidelines state that codes for psychoactive substance use disorders (e.g., F12.90, ‘Cannabis use, unspecified, uncomplicated’) should be reported only when the psychoactive substance use is associated with a physical, mental, or behavioral disorder and the relationship is documented in the physician's note for the encounter,” she writes in Coding & Documentation. “According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), patients with mild substance use disorders have two or three of 11 symptoms. Also note that the term ‘uncomplicated’ in the ICD-10 code descriptor should not be seen as prohibiting use of the code when mild substance use is documented and meets ICD-10 reporting criteria.”

    Read answers to readers’ Coding & Documentation questions in every issue of FPM.

    Posted on Nov 21, 2019 by FPM Editors

    Disclaimer: The opinions and views expressed here are those of the authors and do not necessarily represent or reflect the opinions and views of the American Academy of Family Physicians. This blog is not intended to provide medical, financial, or legal advice. All comments are moderated and will be removed if they violate our Terms of Use.