Official diagnosis coding guidance for 2019 healthcare encounters and deaths associated with e-cigarette, or vaping, product use associated lung injury (EVALI) was released Oct. 17. Until we have more specific codes, we are instructed to “Assign as many codes, as appropriate.”

According to this ICD-10-CM Official Coding Guidelines – Supplement “Coding encounters related to E-cigarette, or Vaping, Product Use,” we can expect new diagnosis codes for EVALI next year. Until then, the guidance in this supplement should be used in conjunction with current ICD-10-CM codes and the ICD-10-CM Official Guidelines for Coding and Reporting.

General Guidance for EVALI Encounters

For patients documented with EVALI, assign the code for the specific condition.

For patients with 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.

For children and adults who have been poisoned by swallowing, breathing, or absorbing-cigarette liquid through their skin or eyes, assign T65.291- Toxic effect of other tobacco and nicotine, accidental (unintentional), which includes toxic effect of other tobacco and nicotine NOS. A seventh digit is required.

For a patient diagnosed with acute tetrahydrocannabinal (THC) toxicity, assign code T40.7X1- Poisoning by cannabis (derivatives), accidental (unintentional). A seventh digit is required.

For patients with documented substance use, abuse, and/or dependence, additional codes identifying the substances used should be assigned, as such:

• If both use and abuse are documented, assign only the code for abuse.
• If both abuse and dependence are documented, assign only the code for dependence.
• If use, abuse, and dependence are documented, assign only the code for dependence (F17.29- Nicotine dependence, other tobacco product. A sixth digit is required.).
• If both use and dependence are documented, assign only the code for dependence.

For patients presenting with any signs/symptoms of EVALI, and where a definitive diagnosis has not been established, assign the appropriate code(s) for each of the presenting signs and symptoms.

Download the official Vaping Coding Guidance 2019.