Note: alcohol poisoning and intoxication should not be assigned together on the same event record. The more common scenario is that alcohol is consumed as a part of the overdose and in these cases it is appropriate to assign the poisoning code T51.0 Toxic effect of ethanol. In the limited circumstances detailed in the query (ie, the alcohol consumption is clearly documented to be a distinct event from the drug consumption) it is appropriate to code the alcohol as intoxication (F10.0) and not as poisoning. In these limited circumstances can we code the Zopiclone overdose with alcohol intoxication (F10.0 Mental and behavioural disorders due to use of alcohol, acute intoxication)? Or must we include the alcohol in the list of drugs in the overdose? At no point in the clinical record was the alcohol documented as anything other than intoxication. The conversation turned sour and some hours later the patient returned home and took an overdose of Zopiclone. We often have documentation of a drug overdose taken in the context of alcohol intoxication, in which the alcohol consumption is documented to be a distinct event from the drug consumption.Īn example is a patient who was out drinking with his partner and flatmates. See also ACS 0503 Drug, alcohol and tobacco use disorders. Where there is no documentation within the clinical record to support code assignment from category F10 Mental and behavioural disorders due to use of alcohol, coders may record alcohol involvement in the NMDS event supplementary field. The code for alcohol use cannot be routinely assigned, as is done for tobacco use because of the subjective nature of its usage (ie, when looking at age, sex, weight issues etc), and that code assignment is dependent on the condition meeting the criteria in ACS 0002 Additional diagnoses. Therefore, assign Z72.1 Alcohol use where there is documentation indicating hazardous use of alcohol and it is relevant to the current episode of care. In contrast to harmful use, hazardous use refers to patterns of use that are of public health significance despite the absence of any current disorder in the individual user'. 'Hazardous use is a pattern of substance use that increases the risk of harmful consequences for the user. The Note at category Z72 Problems related to lifestyle states:
Z72.1 Alcohol use should not be routinely assigned for cases where there is documentation of alcohol involvement with an injury. Therefore, a current dementia code from range F00-F03 is to be assigned as an additional diagnosis with code F05.8 and a code/s for the general medical condition.Ĭan we assign Z72.1 Alcohol use when alcohol was involved with an injury? in a patient who also has dementia and documentation states that the acute confusional state/delirium is due to a general medical condition, assign F05.8 Other delirium in addition to the general medical condition (other than dementia).'.The Coding Rule states: ' where acute confusional state/delirium is specifically documented: The IHACPA Coding Rule Q2649 Confusion or delirium with dementia was updated June 2022 as part of Twelfth Edition. If the dementia does not meet ACS 0002 Additional diagnoses, can the supplementary code U79.1 Dementia (including in Alzheimer's disease) be assigned rather than a code from the range F00-F03 (or F1-.5)? Or does the Coding Rule Q2649 Confusion or delirium with dementia override this and we continue to assign the appropriate dementia code? A patient is admitted with delirium secondary to urinary tract infection (UTI) and has a background of dementia.
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