Q&A: Reporting vaping-related lung injuries in ICD-10-CM
Q: We are finding that physician documentation is lacking for vaping-related lung injuries at our hospital, making it hard to report the condition accurately. What can our coding team do to remedy this situation, and how do we accurately report vaping-related lung injuries in ICD-10-CM?
A: Since vaping-related lung injury is a fairly new diagnosis, I can see how it could be a challenge obtaining supporting documentation and correctly reporting this lung condition. Communication with physicians and providers is the key to obtaining documentation that will support known or suspected cases of vaping-related lung injury.
You will find diagnoses that capture vaping-related lung disease under ICD-10-CM code categories J68.- (respiratory conditions due to inhalation of chemicals, gases, fumes and vapors) and J69.- (pneumonitis due to solids and liquids).
The Centers for Disease Control and Prevention recently published official guidance on appropriate reporting for these conditions. According to the guidelines, coders and providers should take the following components into consideration when selecting the most specific ICD-10-CM codes:
- Coders must assign the code for the specific condition, such as:
- J68.0, bronchitis and pneumonitis due to chemicals, gases, fumes and vapors
- J69.1, pneumonitis due to inhalation of oils and essences
- J80, acute respiratory distress syndrome
- If the patient has been poisoned by swallowing, breathing, or absorbing e-cigarette liquid through their skin or eyes, the coder should assign a code from subcategory T65.291- (toxic effect of other nicotine and tobacco, accidental [unintentional]).
- For a patient with acute tetrahydrocannabinol toxicity, assign a code from subcategory T40.7X1- (poisoning by cannabis [derivatives] accidental [unintentional]).
- In cases where the patient presents with documented substance use, abuse, or dependence, the coder must report an additional code to identify the substances that are being used or abused.
- Coders should report ICD-10-CM codes for all presenting signs and symptoms that have been definitively diagnosed by the provider. These may include:
- M79.10, myalgia, unspecified site
- R06.00, dyspnea, unspecified
- R06.02, shortness of breath
Other respiratory conditions may coexist or develop during hospitalization that will be reportable such as acute hypoxic respiratory failure and pneumonia. Critically ill patients may also develop acute respiratory distress syndrome or require mechanical ventilation. Peripheral extracorporeal membrane oxygenation for supportive care has been reported as well.
Editor’s note: Adriane Martin, DO, FACOS, CCDS, vice president of Enjoin in Eads, Tennessee, answered this question.
This answer was provided based on limited information. Be sure to review all documentation specific to your own individual scenario before determining appropriate code assignment.
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