ICD-10 F17 Codes: Nicotine & Tobacco

The ICD-10 code for tobacco dependence is F17.210 for cigarette smokers — and that single answer hides a category with more structural quirks than any other substance family. F17 is the only F10–F19 category with no abuse or unspecified-use stems, the only one with product-specific 5th characters, and the one most entangled with Z-codes (Z72.0 tobacco use, Z87.891 personal history). It also appears on more charts than any other substance code: most SUD facility patients smoke or vape, and accreditation standards increasingly require facilities to address it.

This guide covers every billable F17 code in the FY2026 ICD-10-CM code set, the F17.2- vs Z72.0 vs Z87.891 triangle, vaping coding, and how tobacco documentation connects to billable cessation counseling.

All codes verified against the FY2026 ICD-10-CM tabular list ( CMS ICD-10-CM files ↗ ), effective October 1, 2025. Part of the ICD-10 behavioral health directory.

F17 at a glance: a different structure

Every other family in the F10–F19 block uses three severity stems (.1- abuse,.2- dependence,.9- unspecified use). F17 has exactly one: F17.2-, nicotine dependence. There are no F17.1- or F17.9- codes in the FY2026 code set. Tobacco involvement below the dependence threshold is handled outside the F-codes entirely — that’s what Z72.0 is for.

Instead of severity stems, F17 spends its 5th character on the product:

The 6th character then carries the clinical status: 0 uncomplicated, 1 in remission, 3 with withdrawal, 8 with other nicotine-induced disorders, 9 with unspecified nicotine-induced disorders.

The FY2026 tabular places four Excludes1 notes at the F17 category level: history of tobacco dependence (Z87.891), tobacco use NOS (Z72.0), tobacco use during pregnancy/childbirth/puerperium (O99.33-), and toxic effect of nicotine (T65.2-). Each of those conditions is coded instead of — never alongside — an F17 code for the same circumstance.

Complete F17 code table (FY2026)

All 20 billable F17 codes:

F17.20- — Nicotine dependence, unspecified product

F17.21- — Nicotine dependence, cigarettes

F17.22- — Nicotine dependence, chewing tobacco

F17.29- — Nicotine dependence, other tobacco product

Note what F17 lacks compared to its siblings: no intoxication codes, no induced mood/psychotic/anxiety disorder codes — the “induced disorders” slots are generic 8/9 characters. Nicotine’s clinical footprint in ICD-10-CM is dependence, remission, and withdrawal.

Patient uses multiple substances? Tobacco co-occurs with nearly every other substance use disorder, and F17 codes are reported alongside the other family’s codes — each substance gets its own code. For the other/unknown-substance rules, see the F19 guide.

F17.2- vs Z72.0 vs Z87.891: the triangle that decides the code

The most common tobacco-coding error is picking the wrong corner of this triangle. The FY2026 tabular draws the lines explicitly with Excludes1 notes in both directions:

Three operational notes:

• Never report two corners together for the same patient encounter. The Excludes1 relationships make F17.2-, Z72.0, and Z87.891 mutually exclusive descriptions of one patient’s tobacco status.
• “In remission” vs “history” is a clinical judgment. F17.211 (dependence, in remission) and Z87.891 (history) can describe similar patients — the difference is whether the provider is still tracking an active-but-remitting disorder or recording a closed historical fact. Coders follow the provider’s wording; providers should be deliberate about it.
• The choice moves quality measures and claims. F17.2- documents an active diagnosis that supports cessation-treatment billing and risk adjustment; Z72.0 flags a risk factor; Z87.891 feeds history-driven screening logic. Mislabeling a dependent smoker as Z72.0 understates acuity and can strip support from cessation-counseling claims.

Coding vaping and e-cigarettes

ICD-10-CM has no vaping-specific dependence code. Nicotine dependence involving e-cigarettes or vaping devices is coded under F17.29- (other tobacco product) — F17.290 uncomplicated, F17.291 in remission, F17.293 with withdrawal.

Two adjacent concepts are coded elsewhere:

For adolescent and young-adult programs, vaping is now the dominant nicotine presentation at intake; F17.290 with clear product documentation (“nicotine dependence, e-cigarette”) is the defensible pattern.

• EVALI (e-cigarette or vaping product use-associated lung injury) codes to U07.0 — the FY2026 Alphabetic Index entries for “vaping (associated) (device) (product) (use),” “e-cigarette (related),” and “EVALI” all point to U07.0. That is a lung-injury code, not a dependence code; a vaping-dependent patient with EVALI gets both U07.0 and F17.29-.
• Non-nicotine vaping (e.g., cannabis vaping) codes to the substance actually used — THC vaping with cannabis use disorder belongs in F12, not F17.

Nicotine withdrawal (F17.2x3)

Nicotine withdrawal gets its own 6th character (3) on every product line: F17.203, F17.213, F17.223, F17.293. It matters most in residential and inpatient SUD settings, where admission abruptly restricts access and withdrawal symptoms (irritability, insomnia, concentration problems, craving) complicate early treatment.

Documentation supporting a withdrawal code should record the symptom cluster and onset relative to last use — not just “patient smokes.” Remission coding follows the same rule as the rest of the block: the ICD-10-CM Official Guidelines, Section I.C.5.b.3 ( FY2026 guidelines ↗ ), require the provider’s explicit documentation of remission before F17.2x1 codes are assigned. The FY2026 tabular’s inclusion terms under the remission codes map DSM-5-TR tobacco use disorder severities (mild through severe, early or sustained remission) onto the single in-remission code per product line.

The use–abuse–dependence hierarchy in Section I.C.5.b.2 barely applies to F17 — with only a dependence stem, there is no abuse/use code to outrank. Documentation of tobacco use without dependence simply exits the F-codes to Z72.0.

Why F17 matters at SUD facilities

Tobacco documentation is easy to treat as background noise — every chart has it, it rarely drives the admission. Three reasons to code it deliberately:

• Accreditation and licensure expectations. Joint Commission and CARF-accredited programs are expected to screen for tobacco use and offer or refer for cessation support, and a growing number of state behavioral health licensure rules require tobacco-free campus policies with cessation programming. Consistent F17 coding is the documentation trail that those screenings happened.
• Mortality stakes. People with serious mental illness and substance use disorders smoke at far higher rates than the general population and die disproportionately of tobacco-related disease — addressing nicotine during SUD treatment is increasingly standard of care rather than an afterthought.
• It unlocks billable services. Cessation counseling is separately reimbursable (next section), but only when the diagnosis supports it.

Billing tobacco cessation: 99406 and 99407

Smoking and tobacco-use cessation counseling has dedicated CPT codes that pair naturally with F17 diagnoses:

Medicare covers tobacco cessation counseling for beneficiaries who use tobacco, and commercial payers broadly reimburse 99406/99407 when time and counseling content are documented. The clean claim pattern at a behavioral health facility: F17.2- as the supporting diagnosis, the counseling note recording minutes spent and cessation content delivered, and 99406/99407 billed alongside (not bundled into) the primary therapy service per payer rules. Full service-code context lives in our CPT directory.

For facilities running structured programs, intake assessment ( H0001 ) and counseling codes ( H0004, H0005 ) document the SUD-side services, with cessation counseling layered on top. Revenue-cycle teams should audit whether F17 diagnoses on charts are actually generating 99406/99407 claims — unbilled cessation counseling is one of the most common leakage points in behavioral health billing.

• CPT 99406 — intermediate cessation counseling, 3–10 minutes
• CPT 99407 — intensive cessation counseling, greater than 10 minutes

Treatment planning for nicotine dependence

Unlike most of the F10–F19 block, nicotine dependence has multiple FDA-approved medications — nicotine replacement therapies (patch, gum, lozenge), bupropion, and varenicline — plus well-validated brief-counseling models (clinical overview only; prescribing belongs to the medical team). Treatment plans at SUD facilities typically set a quit date or reduction schedule, pair medication with counseling, and track status at each plan review.

SMART-goal framing works naturally here: “Patient will reduce cigarette use from 20 to 10 per day within 30 days, verified by self-report and CO monitoring where available.” Build the diagnosis-anchored plan with our treatment plan templates and SMART goals guide.

FAQ

What is the ICD-10 code for tobacco use? Tobacco use without documented dependence is Z72.0. With dependence, use the F17.2- family — F17.210 for cigarettes.

What is the ICD-10 code for tobacco dependence? F17.210 (cigarettes, uncomplicated) is the most common. Product variants: F17.200 unspecified, F17.220 chewing tobacco, F17.290 other products including vaping.

What is the vaping ICD-10 code? Nicotine dependence via e-cigarettes: F17.290 (uncomplicated). Vaping-associated lung injury (EVALI) is U07.0.

What is the nicotine withdrawal code? F17.203 / F17.213 / F17.223 / F17.293 — the 6th character 3 on the product line documented.

What is the former smoker code? Z87.891, personal history of nicotine dependence — for patients who quit and no longer carry an active dependence diagnosis.

Can I bill for cessation counseling at an SUD facility? Yes — CPT 99406 (3–10 min) and 99407 (>10 min) with a supporting F17.2- diagnosis and time-based documentation.

• CMS, FY2026 ICD-10-CM Code Descriptions and Tabular List (effective Oct 1, 2025) — cms.gov/medicare/coding-billing/icd-10-codes ↗ (accessed 2026-06-12)
• CMS, FY2026 ICD-10-CM Official Guidelines for Coding and Reporting, Section I.C.5.b — fy-2026-icd-10-cm-coding-guidelines.pdf ↗ (accessed 2026-06-12)
• CDC/NCHS, ICD-10-CM — cdc.gov/nchs/icd/icd-10-cm ↗ (accessed 2026-06-12)

Reference tables

Common questions

Official sources

• CMS ICD-10-CM filescms.gov
• FY2026 guidelinescms.gov
• cdc.gov/nchs/icd/icd-10-cmcdc.gov