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Bolster your knowledge of this growing epidemic.

Since 2014, e-cigarettes (vapes) have been the most commonly used tobacco product among U.S. middle and high school students, according to the . Besides being an addiction problem among teens and young adults, vaping is also a medical coding problem because there are no vaping dependency codes, and there鈥檚 only one vaping disorder code.

So, it鈥檚 important for otolaryngology coders to understand how to code for vaping and vaping-related conditions. That means clearing up misconceptions and understanding the health hazards involved.

Avoid Dangerous Misconceptions

Many people are under the impression that vaping, or dabbing as it is known when marijuana is vaped instead of nicotine, involves inhaling a mist that contains water and safe or no levels of nicotine. This is false: the mist contains nicotine, as well as carcinogens, formaldehyde, and metal particles such as, nickel, tin, and lead. The tar is 鈥溾�� toxic. It damages the lungs, and it can ruin your teeth by rotting and blackening them. It can damage your gums, and it can even ruin your sense of taste,鈥� according to Sarah Ragan, COC, CPC, CPMA, CRC, CFPC, 星空入口Approved Instructor, during her Regional HEALTHCON presentation, 鈥淰aping: An Epidemic Just Waiting to Happen.鈥�

Additionally, the mist contains carbon monoxide, which is a potentially lethal gas that鈥檚 flammable, odorless, colorless, hazardous, and affects cell metabolism. It binds to heme in the blood, which carries oxygen to body tissue. When it bonds with the heme, it disrupts the release of oxygen.

Understand Vaping Health Hazards

There are many vaping hazards that might concern your otolaryngologist. The article 鈥溾�� in the journal Evidence-Based Dentistry (EBD) noted that among the 32 studies cited in the article, 鈥渟eventeen reported the occurrence of cough alongside symptoms such as sore throat, dry mouth or throat, as well as mouth or throat irritation.鈥� These symptoms were resolved within several months for most cases; however, one study documented symptoms persisting even after 24 months.

Additionally, according to the , ingredients often used in e-liquids are known to cause cancer, and people who vape may switch to smoking cigarettes, which contain even higher amounts of carcinogens and harmful chemicals.

Code These Common Vape-Related Conditions

There are two common vaping-related conditions you may encounter while coding: bronchiolitis obliterans syndrome (BOS) and e-cigarette or vaping-associated lung injury (EVALI). With BOS, the signs and symptoms are an overabundance of mucus. It is coded to J44.81 (Bronchiolitis obliterans and bronchiolitis obliterans syndrome).

EVALI shares many of the same symptoms as lung infections like pneumonia, so healthcare providers will treat EVALI patients using antibiotics, antivirals, corticosteroids, inhalers, nebulizers, oxygen therapy, and mechanical ventilation. You鈥檒l assign U07.0 (Vaping-related disorder) to document an EVALI diagnosis.

You鈥檒l use the code for dabbing-related lung damage or injury and e-cigarette-related lung damage or injury, and you should only use it when the documentation shows the patient has been injured by vaping. This information is usually located in areas of the provider鈥檚 note, like in the chief complaint, history of present illness (HPI), physical exam, and assessment plan. You can also use a code from F17.- (Nicotine dependence) any time, even without a current sickness or injury in the report, according to Ragan.

Add These EVALI Manifestations

You鈥檒l also assign the following codes as applicable for manifestations per the Use additional code note accompanying U07.0:

• R10.84 (Generalized abdominal pain)
• J80 (Acute respiratory distress syndrome)
• R19.7 (Diarrhea, unspecified)
• J70.4 (Drug-induced interstitial lung disorders, unspecified)
• J69.1 (Pneumonitis due to inhalation of oils and essences)
• R63.4 (Abnormal weight loss)

The EBD article also listed a number of other conditions linked to vaping that your otolaryngologist would likely treat:

• H81.- (Disorders of vestibular function)
• H91.0- (Ototoxic hearing loss)
• R49.- Voice and resonance disorders)
• J01.- (Acute sinusitis)
• J30.- (Vasomotor and allergic rhiniti)).
• B37.0- (Candidal stomatitis), also known as oral thrush
• (K13.3- (Hairy leukoplakia), also known as hairy tongue
• K13.24 (Leukokeratosis nicotina palati), also known as nicotine stomatitis or smoker鈥檚 palate

Wait for More Vaping Diagnosis Codes

Despite the existence of U07.0, ICD-10-CM needs more codes to accurately capture a vaping diagnosis because there are no vaping dependence codes. 鈥淭o me it鈥檚 so shocking, considering we just saw the ICD-10-CM updates for 2025, and we got some amazing new codes that came through; but, for some reason this has been left out, and I don鈥檛 know why,鈥� Ragan said.

鈥淲e鈥檙e missing out on an opportunity here, and I think that as vaping becomes even more popular, this is going to be information that we wish we had that we don鈥檛 have.鈥�

Michelle A. Dick, BS, AAPC, Contributing Writer