New Code for E-Cigarette/Vaping Associated Lung Injury (EVALI Code)

EVALI CodeEmergency release of the new EVALI code by CDC.

On Dec. 9, 2019, the Centers for Disease Control and Prevention (CDC) published additional guidance regarding e-cigarette/vaping associated lung injury (EVALI Code). The new code is U07.0 (Vaping-related disorder).

The CDC consulted with the World Health Organization (WHO) regarding an addition to the classification that would be consistent with it. The code became effective Sept. 24, 2019.

Even though the code is available for use now, it is suspected that it has not been included in current encoder software or the MS-DRG methodology or Hierarchical Condition Categories (HCCs). According to the CDC, the code can be reported beginning April 1, 2020. This is a rare instance of a new diagnosis code added in April. To date, ICD-10-CM does not have a U code. There should be additional guidance published in Coding Clinic regarding this latest code addition.

The CDC has been following EVALI Code throughout the year. As of Dec. 10, the CDC reports that 2,409 patients have been impacted by this condition, with 52 deaths, across all 50 states and two territories. The deaths have been reported in 26 states. The rate of newly reported cases is slowing, but new cases are being identified each week. The CDC is only reporting hospitalized cases at the present time. The CDC website publishes a weekly update regarding this condition.

Vitamin E acetate has been identified as a substance of concern. Vitamin E acetate is an additive to some vapes that contain tetrahydrocannabinol (THC). THC is the psychoactive substance in cannabis or marijuana. There is concern about heated vitamin E acetate when it is inhaled. The CDC has been reviewing samples from bronchoalveolar lavage (BAL) and found vitamin E acetate in these samples.

The CDC and FDA (Federal Drug Administration) recommend that people not use e-cigarettes or vaping products that contain THC. Many of the EVALI Code patients have reported buying their products from an “informal” source. The CDC also states that vaping products should NOT be used by adolescents.

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