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Stop holding your breath: The CDC has released guidance for coding EVALI

Coders who wanted help reporting lung injuries associated with vaping can breathe easy. The CDC released information on the diagnosis codes that can be used for e-cigarette, or vaping, product use associated lung injury (EVALI) on Oct 17.
“Proposals for new codes that are intended to address additional detail regarding use of e-cigarette, or vaping, products will be presented at the March 2020 ICD-10 Coordination and Maintenance Committee Meeting,” the CDC states in its guidance.
Here’s a quick gloss of the CDC release; see the full supplement and upcoming issues of Part B News for more details.
The clinician documents EVALI
Assign a code for the specific condition such as bronchitis or pneumonitis, the CDC states. Possible codes include but are not limited to:
  • (Bronchitis and pneumonitis due to chemicals, gases, fumes and vapors; includes chemical pneumonitis).
  • (Pneumonitis due to inhalation of oils and essences; includes lipoid pneumonia)
  • (Acute respiratory distress syndrome).
The clinician does not document EVALI
Report J68.9 (Unspecified respiratory condition due to chemicals, gases, fumes, and vapors) when the clinician documents an acute lung injury but doesn’t document a specific condition.
Turn to codes for the documented signs or symptoms if the clinician hasn’t documented a definitive diagnosis, the new guidance states. Related conditions could go beyond respiratory symptoms such as wheezing, difficulty breathing and abnormally rapid breathing, the CDC notes. The guidance includes such diagnoses as myalgia, abdominal pain, nausea, vomiting, fever and abnormal weight loss.
Report poisoning by e-cigarette liquid that contains nicotine with T65.291- and acute tetrahydrocannabinol toxicity with diagnosis code T40.7X1-. Note that you’ll need to select the appropriate seventh character for these codes.
Use, abuse, dependence
Follow the rules at I.C.5.b.2 in the ICD-10-CM guidelines to code a patient’s substance, use, abuse or dependence. To code nicotine dependence for a patient who vapes, select a code from the F17.29 (Nicotine dependence, other tobacco product, uncomplicated) code family. “Electronic nicotine delivery systems (ENDS) are non-combustible tobacco products,” the CDC states.
Watch for more guidance
The update supplements the guidelines in your ICD-10-CM FY2020 manual and you should check the CDC from time-to-time. “As necessary, this guidance will be updated as new clinical information becomes available,” the CDC writes.
Blog Tags: ICD-10
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