Pneumonitis from Vaping

laura.rogers@franciscanalliance.orglaura.rogers@franciscanalliance.org
in Clinical & Coding

Our college-town hospitals are beginning to see young adults with pneumonitis from vaping.  From the literature searches, this seems to be classed as a hypersensitivity pneumonitis from the chemicals in the pods rather than a water-based pneumonitis like drowning.  The treatment tends to be steroids with ventilator support in severe cases. 

J680 "Bronchitis and pneumonitis due to chemicals, gases, fumes and vapors" seems to be to be the closest match I have found, but our Coding department is not sure it is the best fit. 

What diagnosis code are you using for these cases?

Thanks you so much!

Laura Rogers 

Franciscan Alliance

Indianapolis IN

Comments

  • evanspx@sutterhealth.orgevanspx@sutterhealth.org
    I agree.

    P. Evans
  • BTC2018BTC2018
    Hypersensitivity Pneumonitis is due to dust, fungus or molds, so that does not seem to fit. If no specific substance is identified, J68.0 with T59.9- code (see code first under J68-) when stated as pneumonitis. If THC is identified as causative agent, T40.7X5- sequenced first.
  • buddy.morganIII@providence.orgbuddy.morganIII@providence.org
    edited November 2019
    From our coding team:

    "A supplement to the ICD-10-CM Official Guidelines for Coding and Reporting was released that provides electronic cigarette (e-cigarette), or vaping, product use coding guidance. This guidance has been approved by the four Cooperating Parties (AHIMA, American Hospital Association, Centers for Medicare & Medicaid Services, and National Center for Health Statistics). 

    For patients documented with e-cigarette or vaping product use associated lung injury (EVALI), assign the code for the specific condition, such as code J68.0, Bronchitis and pneumonitis due to chemicals, gases, fumes and vapors. For patients with acute lung injury but without further documentation identifying a specific condition (pneumonitis, bronchitis), assign code J68.9, Unspecified respiratory condition due to chemicals, gases, fumes, and vapors. For patients with documented substance use/abuse/dependence, additional codes identifying the substance(s) used should be assigned. For vaping of nicotine, assign code F17.29-, Nicotine dependence, other tobacco product. Electronic nicotine delivery systems (ENDS) are non-combustible tobacco products."

    I hope that helps!
    BMorgan
  • whitneyarellanowhitneyarellano
    This document should help. https://www.cdc.gov/nchs/data/icd/Vapingcodingguidance2019_10_17_2019.pdf
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