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11 2A's+R ASK about tobacco use: "Do you currently smoke or use otherforms of tobacco?" ADVISE the patient to quit: "Quitting tobacco is one of the best thingsyou can do for your health. I strongly encourage you to quit Are you interested in quitting?" REFER the patient to resources: IF READY TO QUIT: Provide direct referrals to resources that will assist the patient in quitting. Provide direct referrals. Prescribe medications, if appropriate. IF NOT READYTO QUIT: Strongly encourage patients toconsider quitting by using personalized motivational messages. Let them knowyou are there to help them when they are ready.
12 Free telephone-based state tobacco quitlines: The National Cancer Institute s website: The National Cancer Institute s text-messaging quit smoking program: SmokefreeTXT; The Department of Health and Human Services website:
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15 ICD-10 Tobacco Diagnostic Codes (Replaces ICD-9 Code 305.1): F17.2 (nicotine dependence), (smoking complicating pregnancy, childbirth, and the puerperium), P04.2 (newborn affected by maternal use of tobacco), P96.81 (exposure to environmental tobacco smoke in the perinatal period), T65.2 (toxic effect of tobacco and nicotine), Z57.31 (occupational exposure to environmental tobacco smoke), Z71.6 (tobacco use counseling, not elsewhere classified), Z72 (tobacco use not otherwise specified (NOS), Z77.2 (contact with and exposure to environmental tobacco smoke), and Z87.8 (history of nicotine dependence). (Each of these codes are often used with modifier(s) to specifically define the type of tobacco use or exposure.) ICD-10 Diagnostic Codes for Nicotine Dependence, effective October 1, 2015 F17 Nicotine Dependence Excludes1: History of tobacco dependence (Z87.891); tobacco use not otherwise specified (NOS) (Z72.0) Excludes2: Tobacco use (smoking) during pregnancy, childbirth and the puerperium (O99.33); toxic effect of tobacco and nicotine (T65.2) see below
16 ICD-10 Tobacco Diagnostic Codes (Replaces ICD-9 Code 305.1), con t: F17.2 Nicotine dependence F17.20 Nicotine dependence, unspecified F Nicotine dependence, unspecified, uncomplicated F Nicotine dependence, unspecified, in remission F Nicotine dependence unspecified, with withdrawal F Nicotine dependence, unspecified, with other nicotine-induced disorders F Nicotine dependence, unspecified, with unspecified nicotine-induced disorders F17.21 Nicotine dependence, cigarettes F Nicotine dependence, cigarettes, uncomplicated F Nicotine dependence, cigarettes, in remission F Nicotine dependence, cigarettes, with withdrawal F Nicotine dependence, cigarettes, with other nicotine-induced disorders F Nicotine dependence, cigarettes, with unspecified nicotine-induced disorders F17.22 Nicotine dependence, chewing tobacco F Nicotine dependence, chewing tobacco, uncomplicated F Nicotine dependence, chewing tobacco, in remission F Nicotine dependence, chewing tobacco, with withdrawal F Nicotine dependence, chewing tobacco, with other nicotine-induced disorders F Nicotine dependence, chewing tobacco, with unspecified nicotine-induced disorders F17.29 Nicotine dependence, other tobacco product F Nicotine dependence, other tobacco product, uncomplicated F Nicotine dependence, other tobacco product, in remission F Nicotine dependence, other tobacco product, with withdrawal F Nicotine dependence, other tobacco product, with other nicotine-induced disorders F Nicotine dependence, other tobacco product, unspecified nicotine-induced disorders
17 ICD-10 Tobacco Diagnostic Codes (Replaces ICD-9 Code 305.1) con t : Maternal Tobacco Use and Exposure (099.3, P04.2, P96.8) O99 Maternal diseases classified elsewhere but complicating pregnancy, childbirth, and the puerperium O99.3 Mental disorders and diseases of the nervous system complicating pregnancy, childbirth and the puerperium O99.33 Smoking (tobacco) complicating pregnancy, childbirth, and the puerperium Use additional code from F17 to identify type of tobacco O Smoking (tobacco) complicating pregnancy, unspecified trimester O Smoking (tobacco) complicating pregnancy, first trimester O Smoking (tobacco) complicating pregnancy, second trimester O Smoking (tobacco) complicating pregnancy, third trimester O Smoking (tobacco) complicating childbirth O Smoking (tobacco) complicating the puerperium P04 Newborn (suspected to be) affected by noxious substances transmitted via placenta or breast milk P04.2 Newborn (suspected to be) affected by maternal use of tobacco Newborn (suspected to be) affected by exposure in utero to tobacco smoke Excludes2: Newborn exposure to environmental tobacco smoke (P96.81) P96 Other conditions originating in the perinatal period P96.8 Other specified conditions originating in the perinatal period P96.81 Exposure to (parental) (environmental) tobacco smoke in the perinatal period
18 ICD-10 Tobacco Diagnostic Codes (Replaces ICD-9 Code 305.1) con t : Toxic Effect of Tobacco and Nicotine (T65.2) T65 Toxic effect of other and unspecified substances T65.2 Toxic effect of tobacco and nicotine Excludes2: Nicotine dependence (F17.2) T65.21Toxic effect of chewing tobacco T Toxic effect of chewing tobacco, accidental (unintentional) Toxic effect of chewing tobacco not otherwise specified (NOS) T Toxic effect of chewing tobacco, intentional self-harm T Toxic effect of chewing tobacco, assault T Toxic effect of chewing tobacco, undetermined T65.22Toxic effect of tobacco cigarettes Toxic effect of tobacco smoke Use additional code for exposure to second hand tobacco smoke (Z57.31, Z77.22) T Toxic effect of tobacco cigarettes, accidental (unintentional) Toxic effect of tobacco cigarettes not otherwise specified (NOS) T Toxic effect of tobacco cigarettes, intentional self-harm T Toxic effect of tobacco cigarettes, assault T Toxic effect of tobacco cigarettes, undetermined T65.29 Toxic effect of other tobacco and nicotine T Toxic effect of other tobacco and nicotine, accidental (unintentional) Toxic effect of other tobacco and nicotine not otherwise specified (NOS) T Toxic effect of other tobacco and nicotine, intentional self-harm T Toxic effect of other tobacco and nicotine, assault T Toxic effect of other tobacco and nicotine, undetermined
19 ICD-10 Tobacco Diagnostic Codes (Replaces ICD-9 Code 305.1) con t : Environmental Tobacco Smoke Exposure (Z57.31, Z77.22) Z57 Occupational exposure to risk factors Z57.3 Occupational exposure to other air contaminants Z57.31 Occupational exposure to environmental tobacco smoke (Z57.31) Excludes2: Exposure to environmental tobacco smoke (Z77.22) Z77 Other contact with and (suspected) exposures hazardous to health Z77.2 Contact with and (suspected) exposure to other hazardous substances Z77.22Contact with and (suspected) exposure to environmental tobacco smoke Exposure to second hand tobacco smoke (acute) (chronic) Passive smoking (acute) (chronic) Excludes1: Nicotine dependence (F17.2) tobacco use (Z72.0) Excludes2: Occupational exposure to environmental tobacco smoke (Z57.31) Counseling and Medical Advice Services, Not Elsewhere Classified (Z71.6, Z72.0) Z71 Persons encountering health services for counseling and medical advice, not elsewhere classified Z71.6 Tobacco abuse counseling Use additional code for nicotine dependence (F17.2) Z72 Problems related to lifestyle Z72.0 Tobacco use Tobacco use not otherwise specified (NOS) Excludes1: History of tobacco dependence (Z87.891); nicotine dependence (F17.2); tobacco dependence (F17.2); tobacco use during pregnancy (O99.33) History of (noncurrent) Nicotine Dependence (Z87.891) Z87 Personal history of other diseases and conditions Z87.8 Personal history of other specified conditions Z Personal history of nicotine dependence Excludes1: Current nicotine dependence (F17.2)
20 ICD-10 Tobacco Diagnostic Codes (Replaces ICD-9 Code 305.1) con t : Exclusions: Excludes1 - A type 1 Excludes note is a pure excludes. It means 'NOT CODED HERE!' An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition. Excludes2 - A type 2 excludes note represents 'Not included here'. An excludes2 note indicates that the condition excluded is not part of the condition it is excluded from but a patient may have both conditions at the same time. When an Excludes2 note appears under a code it is acceptable to use both the code and the excluded code together. Sources: The National Center for Health Statistics (NCHS), the Federal agency responsible for use of the International Statistical Classification of Diseases and Related Health Problems in the United States, 10th revision (ICD-10), Fiscal Year Centers for Medicare and Medicaid Services (CMS) - Diseases-and-Injuries.pdf Compiled by the University of Wisconsin Center for Tobacco Research & Intervention ICD-10 Codes Tobacco/Nicotine Dependence and Secondhand Smoke Exposure - October 2015
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22 Source: UMMC- ACT Center for Tobacco Treatment, Education and Research
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