Start using new diagnosis code for vaping-related disorder on April 1

In response to the recent cases of vaping-related disorders, the World Health Organization (WHO) established a new International Classification of Diseases, Tenth Revision (ICD-10) emergency code, U07.0, which can be used in the United States starting April 1.

In addition, a new chapter was added to ICD-10 and the clinical modification (ICD-10-CM), which is used in the United States. Chapter 22 is titled “Codes for Special Purposes” and lists “U” codes (U00-U85) that have been added to the code set. A new section also will be created (U00-U49) for the provisional assignment of new diseases of uncertain etiology or emergency use.

The entry for code U07.0 will have a list of inclusion terms that might be documented in the medical record. A “use additional code” note also needs to be followed when manifestations, such as diarrhea, are documented. Remember to code U07.0 first followed by the manifestations.

U07 Conditions of uncertain etiology

U07.0 Vaping-related disorder

Dabbing related lung damage

Dabbing related lung injury

E-cigarette, or vaping, product use associated lung injury [EVALI]

Electronic cigarette related lung damage

Electronic cigarette related lung injury

Use additional code, to identify manifestations, such as:

abdominal pain (R10.84)

acute respiratory distress syndrome (J80)

diarrhea (R19.7)

drug-induced interstitial lung disorder (J70.4)

lipoid pneumonia (J69.1)

weight loss (R63.4)

While new guidance on coding for health care encounters related to EVALI was posted on Oct. 17, 2019 (see AAP News article at http://bit.ly/2RVrOrE), the vaping-related illness code was not available at that time. The only area of the new guidance that may be impacted by code U07.0 is the section on lung-related complications and vaping.

Vignette

A patient presents to the emergency department with difficulty breathing. The patient admits to vaping. After a full history, exam and diagnostic imaging, the patient is admitted with acute respiratory distress syndrome (ARDS). The code reported for the emergency department encounter isJ80.

After discussions with the patient, the admitting physician determines the patient is using off-brand cartridges that he purchased online. The physician makes a clinical decision that vaping caused the ARDS.

The discharge diagnosis for the patient (on or after April 1) will be:

U07.0

J80.