Great American Smoke Out and I-10

on Friday, 14 November 2014. All News Items | Documentation | Coding

Increased Specificity in I-10

November is Lung Cancer Awareness Month and annually the American Cancer Society has designated the third Thursday of November as the Great American Smokeout “by encouraging smokers to use the date to make a plan to quit, or to plan in advance and quit smoking that day.” We at MMP would also like to use this date to encourage our readers to make a plan and be prepared for the documentation changes for smoking in ICD-10.

In record reviews I have seen doctors note a patient has never smoked, is a smoker, is a reformed smoker, patient has cut back to 2-3 cigarettes a day. While all of this is interesting, currently in ICD-9 physicians simply need to document when a patient smokes or uses tobacco.

However, in ICD-10, physicians will need to provide more detailed documentation. Physicians will need to document the following additional information for the coder to most accurately report a patient’s tobacco use:

  • The physician should document the type of tobacco a person uses (e.g. cigarettes, chewing tobacco, pipe, and/or gum).
  • To further specify the type of tobacco dependence that a patient has, the physician will need to document the frequency of use.
    • The patient uses nicotine, or
    • The patient abuses nicotine, or
    • The patient has a nicotine dependence or
    • The patient is in remission from nicotine.
  • Also, when it is applicable, the physician should document the type of second hand smoke experienced by the patient (e.g. from parent, at work, perinatal, etc.).

Take a look at what your physicians are currently documenting about tobacco use and begin to educate your physicians on what needs to be documented for the accurate reporting of tobacco use.

Article by Beth Cobb

Beth Cobb, RN, BSN, ACM, CCDS, is the Manager of Clinical Services at Medical Management Plus, Inc. Beth has over twenty-three years of experience in healthcare including eleven years in Case Management at a large multi-facility health system. In her current position, Beth monitors, interprets and communicates current and upcoming Case Management / Clinical Documentation issues as they relate to specific entities concerning Medicare. You may contact Beth at This email address is being protected from spambots. You need JavaScript enabled to view it..

This material was compiled to share information. MMP, Inc. is not offering legal advice. Every reasonable effort has been taken to ensure the information is accurate and useful.

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