Z77.22 — Contact with and (suspected) exposure to environmental tobacco smoke (acute) (chronic)
Z77.22 is a billable, specific ICD-10-CM code for contact with and (suspected) exposure to environmental tobacco smoke (acute) (chronic). It is valid for submission on a claim.
Excludes1 — never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
Excludes2 — not included here, but may coexist
The excluded condition is not part of this code, but a patient can have both. You may code both.
- occupational exposure to environmental tobacco smoke (Z57.31)
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Exposure to second hand tobacco smoke (acute) (chronic)
- Passive smoking (acute) (chronic)
Excludes2 inherited from the categories above Z77.22
Also inherited, and the opposite of Excludes1: these conditions are not part of Z77.22, but a patient can have both, so you may code both.
Written on Z77 — Other contact with and (suspected) exposures hazardous to health
- contact with and (suspected) exposure to communicable diseases (Z20.-)
- exposure to (parental) (environmental) tobacco smoke in the perinatal period (P96.81)
- newborn affected by noxious substances transmitted via placenta or breast milk (P04.-)
- occupational exposure to risk factors (Z57.-)
- retained foreign body (Z18.-)
- retained foreign body fully removed (Z87.821)
- toxic effects of substances chiefly nonmedicinal as to source (T51-T65)
Other codes that can never be billed with Z77.22
These codes carry an Excludes1 note pointing at Z77.22. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading Z77.22 alone.
Risk adjustment
Z77.22 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
Z77.22 is named in 1 Medicare coverage policy — 1 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56448Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography
How Z77.22 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to Z77.22.
- Second hand tobacco smoke exposure(acute) (chronic)
- Exposure›environmental tobacco smoke(acute) (chronic)
- Exposure›second hand tobacco smoke(acute) (chronic)
- Passive›smoking
- Smoking›passive
- Exposure›smoke›tobacco, second hand
Code history
Z77.22 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.
Related codes at this level
Codes that share Z77.2. If Z77.22 is not quite right, the correct code is usually one of these.
Questions about Z77.22
- Is Z77.22 a billable ICD-10-CM code?
- Yes. Z77.22 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does Z77.22 sit in the tabular list?
- Factors influencing health status and contact with health services (Z00-Z99), in the block Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99).
- What cannot be coded together with Z77.22?
- Z77.22 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter.