ICD-10-CM Codes for Tobacco and Cannabis Use
The specific ICD-10-CM codes you need are not explicitly provided in the available clinical guidelines, as these documents focus on clinical definitions and treatment rather than billing/coding systems.
What the Guidelines Actually Address
The evidence provided focuses on clinical definitions and diagnostic criteria rather than administrative coding systems 1. The guidelines discuss:
- Tobacco use status documentation as a vital sign (current, former, never) but do not specify ICD-10-CM codes 1
- Cannabis use history as a binary variable (yes/no/unknown) without corresponding codes 1
- Substance use disorder diagnostic criteria from DSM-5 and ICD-10 classification systems, but these are diagnostic frameworks, not billing codes 1, 2
Clinical Documentation Requirements
For Tobacco
- Document smoking status at every healthcare visit as a vital sign 1
- Assess current use (smoked within last 30 days), former use (>30 days since last use), or never smoker 1
- Quantify exposure in pack-years (1 pack-year = 20 cigarettes/day for 1 year) 1
- Document nicotine dependence severity using validated tools 1, 3
For Cannabis
- Document history of cannabis use (yes/no/unknown) 1
- Assess frequency of use (current user, recent user within 1 year, former user >1 year) 1
- Evaluate for cannabis use disorder using DSM-5 criteria (mild: 2-3 criteria, moderate: 4-5 criteria, severe: ≥6 criteria) 2
- Document presence of tolerance and withdrawal symptoms if present, which establish physiological dependence 2
Important Clinical Distinctions
Cannabis dependence is now recognized with validated withdrawal syndrome including insomnia, irritability, anxiety, and physical discomfort occurring within 24-72 hours of cessation 1, 2. This affects 50-95% of heavy users 2.
Nicotine dependence should be assessed using standardized screening tools that align with ICD-10, DSM-III-R, and DSM-IV criteria 3.
Practical Recommendation
To obtain the specific ICD-10-CM codes you need, consult your facility's coding department or reference the official ICD-10-CM manual, as these administrative codes are not included in clinical practice guidelines. The guidelines provide the clinical framework for diagnosis but not the billing codes themselves.