The WHO Family of International Classifications (WHOFIC) Network Classification and Statistics Advisory Committee (CSAC) convened to establish a new emergency code to be used by WHO. This new emergency code, U07.0 - Vaping-related disorder, was implemented and valid for immediate use as of September 24, 2019, for ICD-10.
In the United States, a Supplement to the ICD-10-CM Guidelines, entitled “Coding Encounters Related to E-cigarette, or Vaping, Product Use,” was posted on October 17, 2019. The guideline update provided valuable information on the proper assigning of codes, but did not provide a unique code for vaping in ICD-10-CM.
It has now been announced that the Centers for Disease Control and Prevention’s National Center for Health Statistics (CDC/NCHS) is also implementing this new diagnosis code to be consistent with the WHO update. The code, U07.0 - Vaping-related disorder, will be effective in the U.S. on April 1, 2020. In addition, “proposals for new codes that are intended to address additional detail regarding use of e-cigarette, or vaping, products will be presented at the March 2020 ICD-10 Coordination and Maintenance Committee Meeting” (CDC, 2019).
Full addenda information for the new code was posted in December 2019 on the CDC website. As part of their outreach and education efforts, the CDC/CNHS provided more information on the implementation of this new ICD-10-CM diagnosis code.
According to the CDC, “electronic cigarettes - or e-cigarettes - are also called vapes, e-hookahs, vape pens, tank systems, mods, and electronic nicotine delivery systems (ENDS)” (CDC, 2020). Using an e-cigarette product is commonly referred to as “vaping.”
The CDC explains that e-cigarettes work by heating a liquid to produce an aerosol that users inhale into their lungs (CDC, 2020). This liquid can contain: nicotine, tetrahydrocannabinol (THC) and cannabinoid (CBD) oils, and other substances and additives. THC is the psychoactive, mind-altering compound of marijuana that produces the “high” (CDC, 2020). A dab vape pen is used to vaporize a liquid form of cannabis, also known as concentrates.
The CDC is investigating this outbreak of e-cigarette, or vaping, product use-associated lung injury (EVALI). All EVALI patients have reported a history of using e-cigarette, or vaping, products (CDC, 2020). According to the CDC, “as of January 14, 2020, a total of 2,668 hospitalized EVALI cases or deaths have been reported to CDC from all 50 states, the District of Columbia, and two U.S. territories (Puerto Rico and U.S. Virgin Islands)” (CDC, 2020).
Recently a breakthrough occurred that showed that Vitamin E acetate has been identified as a chemical of concern among people with e-cigarette, or vaping, product use-associated lung injury (EVALI).
THC is present in most of the samples tested by FDA to date, reveals the Montana Department of Public Health and Human Services (2019), and most patients report a history of using THC-containing e-cigarette, or vaping, products. The site is frequently updated with information for the public.
Why The U-Code?
The ICD-10 classification has previously used U codes assigned to Chapter XXII, Codes for Special Purposes, (U00-U85). Some examples of categories for U codes used in ICD-10 include: U82-U85 - Resistance to antimicrobial and antineoplastic drugs, U04 - Severe acute respiratory syndrome [SARS], and U06 - Zika virus disease. U06-U07 are “active” codes, even though the titles are “Emergency use.” The vaping directive to use U07.0 internationally to represent vaping illustrates the emergency use.
Previously, ICD-10-CM has not used Chapter 22, but it is being added so the code set is consistent with that of WHO. The new block of codes (U00-U85) are for special purposes, identified as “Provisional assignment of new diseases of uncertain etiology or emergency use” (U00-U49). There is also a note at the chapter level that Codes U00-U49 are to be used by WHO for the provisional assignment of new diseases of uncertain etiology.
For more information regarding the new ICD-10-CM code, U07.0 - Vaping-related disorder, review our Hot Topics course on vaping for 1 free CEU. Read up on the impending ICD-11 code set, which is set to go into effect in 2022.