New Zealand Convention on Counselling for Tobacco Use Disorder and Exposure to Tobacco Smoke

Z71.6 Counselling for tobacco use disorder

This New Zealand convention is related to the mandatory reporting requirements aligned to the 2009 Health Target ‘Better help for smokers to quit’.

Z71.6 Counselling for tobacco use disorder is assigned as an additional diagnosis when there is evidence within the clinical record of one or more of the following:

  1. Brief advice to quit including documentation where advice and/or treatment has been offered but declined by patient.
  2. Charting or prescribing of the following pharmacotherapies when used for smoking cessation and/or temporary abstinence purposes for public hospital inpatients.
    • Nicotine replacement therapy (transdermal patch, gum, lozenge, inhaler, microtab)
    • Varenicline (Champix)
    • Bupropion (Zyban)
    • Nortriptyline (documented to aid smoking cessation).
  3. A referral made to a smoking cessation specialist or programme (inpatient or outpatient). This may include any of the following:
    • Hospital Smokefree Team
    • Quitline
    • Aukati Kai Paipa
    • Other local cessation provider.
  4. A referral to General Practitioner or Practice Nurse for follow-up of smoking or tobacco dependence, or smoking cessation, post-discharge from hospital.

Clinical coders are advised to:

  • Include free text in the code description for Z71.6 Counselling for tobacco use disorder, see examples:
    • Z71.6 Counselling for tobacco use – offered NRT – declined
    • Z71.6 Counselling for tobacco use – charted NRT
    • Z71.6 Counselling for tobacco use – referred to Quitline
    • Z71.6 Counselling for tobacco use – advice given
  • contact their Smokefree Coordinators for assistance and support to improve documentation within the clinical record
  • seek classification advice for clinical scenarios where it is difficult to apply this convention. Contact coding_helpdesk@moh.govt.nz.

Z58.7 Exposure to tobacco smoke

Assign the code Z58.7 Exposure to tobacco smoke when:

  • the patient, irrespective of age, has never smoked
    AND
  • has been exposed to tobacco smoke in their home environment, working environment or recreational environment
    OR
  • an infant is born to a mother who has smoked at any time throughout the pregnancy and there is no documented causal relationship between a neonatal condition and the mother’s tobacco usage.

Exclusions

Z58.7 Exposure to tobacco smoke is not assigned when:

  1. The patient has been exposed to tobacco smoke as a one off or incidental encounter which may have exacerbated a chronic condition and/or precipitated an admission to hospital for any other conditions.
  2. When a neonate (0-28 completed days) is born with or is subsequently admitted to hospital with any documented condition specifically attributed to maternal use of tobacco the code P04.2 Fetus and newborn affected by maternal use of tobacco is assigned according to the guidelines in the Australian Coding Standard (ACS) 1609 Newborns affected by maternal causes and birth trauma.

Clinical coders are advised to:

  • Include free text in the code description for Z58.7 Exposure to tobacco smoke, see examples:
    • Z58.7 Exposure to tobacco smoke – parents smoke outside
    • Z58.7 Exposure to tobacco smoke – in utero
    • Z58.7 Exposure to tobacco smoke – partner 2pkt/day
  • read the New Zealand Convention Z58.7 Exposure to tobacco smoke document for more detailed information and assistance with the application of this convention. Z58.7 Exposure to tobacco smoke (PDF, 58 KB)
  • contact their Smokefree Coordinators for assistance and support to improve documentation within the clinical record
  • seek classification advice for clinical scenarios where it is difficult to apply this convention. Contact coding_helpdesk@moh.govt.nz
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