F17.200: Nicotine dependence, unspecified, uncomplicated

The ICD-10-CM code for nicotine dependence when the provider has established dependence but the record names neither the tobacco product nor a complication such as withdrawal or remission.

Billable

FY2027

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At a glance

Code Family

F17: Nicotine dependence

HCC Mapping (v28)

None. F17 is the only category in the F10-F19 block with no code in the CMS-HCC v28 diagnosis crosswalk.

DRG Grouping

MS-DRG 951, Other Factors Influencing Health Status, in MDC 23 under the FY2027 MS-DRG v44 grouper when F17.200 is the principal diagnosis.

Condition

Nicotine dependence

Family Specificity

Twenty billable codes arranged as four tobacco products by five complication states. F17.200 is the cell where neither axis is documented.

Billable

Yes. F17.200 is a six character code with no children.

Which F17 code do I assign?

The F17.2- codes split on two independent axes once dependence itself is established: the tobacco product at the fourth and fifth characters, and the complication at the sixth. All twenty product and complication combinations exist as billable codes, with F17.200 as the cell for a record that documents neither.

When documentation says…

Code

Nicotine dependence or tobacco use disorder with no product named

F17.200

Dependence is established while the product and any complication are not documented. The tabular carries tobacco use disorder, mild, tobacco use disorder, moderate and tobacco use disorder, severe as inclusion terms at F17.200. A DSM-5 severity qualifier on its own does not move the code.

Patient smokes half a pack a day, with no dependence stated

Z72.0

Tobacco use recorded as a lifestyle behavior rather than a diagnosis. Z72.0 carries an Excludes1 note for nicotine dependence (the F17.2 codes). The two are not reported together for the same condition.

Former smoker, quit in 2019

Z87.891

Personal history of nicotine dependence, for a patient who no longer uses tobacco. Z87.891 carries an Excludes1 note for current nicotine dependence (the F17.2 codes). Category F17 carries the reciprocal Excludes1 note for history of tobacco dependence (Z87.891).

Nicotine dependence, cigarettes

F17.210

The product is documented as cigarettes and no complication is stated. Any note that names the product moves the code out of the F17.20- unspecified group.

Nicotine dependence, in remission

F17.201

The dependence diagnosis stays active and is described as in remission. The tabular carries tobacco use disorder in early remission and tobacco use disorder in sustained remission as inclusion terms at F17.201. This is not the same as Z87.891, which states the dependence is no longer present.

Tobacco withdrawal

F17.203

The tabular carries tobacco withdrawal as an inclusion term at F17.203. Withdrawal sits at the sixth character 3 as a complication of the dependence rather than as a separate diagnosis.

Chewing tobacco dependence

F17.220

Chewing tobacco has its own product axis in the F17.22- codes. The Alphabetic Index sends a specified product NEC, such as cigars or a pipe, to the F17.29- codes.

Tabular notes

EXCLUDES1

Category F17 carries Excludes1 notes for history of tobacco dependence (Z87.891) and for tobacco use NOS (Z72.0). An Excludes1 note means the excluded code is not reported with F17.200 for the same condition. Both exclusions are reciprocal in the tabular. Z72.0 carries Excludes1 notes for nicotine dependence (F17.2-), tobacco dependence (F17.2-), history of tobacco dependence (Z87.891) and tobacco use during pregnancy (the O99.33 codes). Z87.891 carries an Excludes1 note for current nicotine dependence (the F17.2 codes).

EXCLUDES2

Category F17 carries Excludes2 notes for tobacco use (smoking) during pregnancy, childbirth and the puerperium (O99.33-) and for toxic effect of nicotine (the T65.2 codes). An Excludes2 note means the patient may have both conditions and both may be coded. Subcategory O99.33 carries its own instruction to use an additional code from category F17 to identify the type of tobacco nicotine dependence. That note places the O99.33 code ahead of F17.200 for a pregnant patient.

FY2027: EFFECTIVE 1 OCTOBER 2026

The FY2027 codes and tabular addenda make no addition, deletion or revision in category F17. F17.200 is unchanged in the FY2027 update. Category F17 received no new or deleted child codes in the FY2026 update effective 1 October 2025. No change to the F17 Excludes1 or Excludes2 notes was identified for FY2026.

Operational & financial impact

Why specificity matters beyond the chart: risk adjustment, DRG assignment and denial exposure all follow from which code is selected.

CMS-HCC v28 (PY2024+)

F17.200 maps to no HCC. The code does not appear in the ICD-10 to HCC crosswalk file distributed with the CMS-HCC v28 model software, F2823T2N_FY22FY23.TXT.

The absence covers the whole family. None of the twenty F17.2- codes appears in that crosswalk. No code in category F17 appears in it at all.

F17 is the only category in the F10-F19 block with no mapped codes. F10 alcohol related disorders map to HCC 136, alcohol use with psychotic complications, and HCC 139, alcohol use disorder, moderate or severe, or alcohol use with specified non-psychotic complications. F11, F12, F13, F14, F15, F16, F18 and F19 map to the drug use categories HCC 135, HCC 137 and HCC 138.

The same absence holds under the earlier model. Category F17 has no rows in the CMS-HCC v24 crosswalk files either.

Nicotine dependence therefore carries no risk adjustment payment weight for Medicare Advantage. The risk score attached to a patient who smokes comes from the tobacco related condition itself, such as J44.9 chronic obstructive pulmonary disease mapping to HCC 280.

MS-DRG v44 (FY2027)

F17.200 as a principal diagnosis groups to MDC 23, factors influencing health status and other contacts with health services, under the FY2027 MS-DRG v44 grouper.

MS-DRG 951: Other Factors Influencing Health Status.

MS-DRG 951 carries no severity split. No CC or MCC reported alongside F17.200 moves the case to another tier.

Medicare and commercial payers

Z71.6, tobacco abuse counseling, carries a Use additional instruction reading code for nicotine dependence (the F17 codes). F17.200 is the code that satisfies that instruction when the product is not documented.

Medicare Part B covers tobacco cessation counseling under two CPT codes. CPT 99406 covers an intermediate session of greater than 3 minutes up to 10 minutes. CPT 99407 covers an intensive session of greater than 10 minutes.

Coverage runs to two cessation attempts per 12 month period. Each attempt allows up to four counseling sessions, for a maximum of eight sessions in a 12 month period.

Low dose CT lung cancer screening under National Coverage Determination 210.14 requires age 50 through 77 and a smoking history of at least 20 pack-years. It also requires current smoking or cessation within the last 15 years. The American Lung Association lung cancer screening billing guide names F17.210 for a patient who currently smokes cigarettes and Z87.891 for a patient who formerly smoked. The choice between F17.2- and Z87.891 on that claim states which side of the 15 year criterion the patient falls on.

MIPS Quality ID 226, Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention, is specified on CPT and HCPCS codes for the 2026 performance period. It does not use ICD-10-CM diagnosis codes. F17.200 does not satisfy the measure numerator.

WHERE SPECIFICITY IS LOST

F17.200 leaves both axes blank. The fourth and fifth characters 20 mean no tobacco product is documented. The sixth character 0 means no complication is documented.

A note reading cigarettes supports the product axis in the F17.21- codes. A note reading chewing tobacco supports the F17.22- codes. A note naming another specified product, such as cigars or a pipe, supports the F17.29- codes.

A note documenting withdrawal symptoms supports the sixth character 3, at F17.203 or at the product specific equivalent such as F17.213.

The choice between F17.200 and Z72.0 changes whether the record asserts a diagnosis or a behavior. Neither code carries a v28 HCC. The Excludes1 notes bar the two codes together for the same condition.

F17.200 requires documentation by the patient's provider. Section I.B.14 of the ICD-10-CM Official Guidelines lists the exceptions to provider based code assignment as body mass index, depth of non-pressure chronic ulcers, pressure ulcer stage, coma scale, NIH stroke scale, social determinants of health classified to Chapter 21, laterality, blood alcohol level, underimmunization status and firearm injury intent. Nicotine dependence is not on that list. A nursing intake form or a self reported smoking status field in the social history does not support F17.200 on its own.

Documentation checklist to support F17.200

Chart elements that support code selection and reduce specificity-driven denials.

A diagnosis of nicotine dependence, tobacco dependence or tobacco use disorder, stated by the patient's provider.

The absence of a named tobacco product in the note, which is what holds the code in the F17.20- group rather than in the F17.21-, F17.22- or F17.29- groups.

The absence of any documented complication, including remission and withdrawal, which is what holds the sixth character at 0.

No concurrent report of Z72.0 tobacco use, Z87.891 personal history of nicotine dependence or Z77.22 exposure to environmental tobacco smoke for the same condition. Each carries an Excludes1 note against nicotine dependence.

Where a DSM-5 severity is recorded, the mild, moderate or severe qualifier, which the tabular carries as an inclusion term at F17.200 and which does not change the code selected.

For a tobacco related condition reported on the same encounter, the documentation that links the two, to satisfy the category level Use additional instruction at the parent condition.

For a cessation counseling encounter, the face to face time and the content discussed, to support CPT 99406 or CPT 99407 alongside Z71.6.

For a pregnant patient, the trimester, to support the O99.33- code that F17.200 is reported beneath.

A dated and signed provider note, since F17.200 cannot be assigned from a non provider source under Section I.B.14.

FAQ

Is F17.200 a billable code?

Yes. F17.200 is a six character code with no children, which makes it valid for submission. All twenty codes in the F17.2- family are billable at six characters.

What is the difference between F17.200, Z72.0 and Z87.891?

F17.200 is a diagnosis of nicotine dependence. Z72.0 is tobacco use recorded as a lifestyle behavior with no dependence stated. Z87.891 is a personal history of nicotine dependence in a patient who no longer uses tobacco. Category F17 carries Excludes1 notes for both Z72.0 and Z87.891. None of the three is reported with another for the same condition.

Does F17.200 map to an HCC?

No. F17.200 does not appear in the CMS-HCC v28 ICD-10 to HCC crosswalk. No other code in category F17 appears in it either. F17 is the only category in the F10-F19 block with no mapped codes. F10 maps to HCC 136 or HCC 139. The other substance categories, F11 to F16, F18 and F19, map to HCC 135, HCC 137 or HCC 138. The same absence holds under CMS-HCC v24.

How is F17.201 in remission different from Z87.891 personal history of nicotine dependence?

F17.201 keeps the dependence diagnosis active and describes it as in remission. The tabular carries tobacco use disorder in early remission and tobacco use disorder in sustained remission as inclusion terms at F17.201. Z87.891 states that the dependence is no longer present. Z87.891 carries an Excludes1 note for current nicotine dependence (the F17.2 codes). F17.201 and Z87.891 are therefore not reported together for the same condition.

How do I sequence F17.200 with the condition it complicates?

F17.200 is the secondary code. The tabular reaches it through Use additional instructions at the parent condition. Chapter 10, diseases of the respiratory system, carries a chapter level instruction to code, where applicable, to identify tobacco dependence (F17.-), which reaches J44 and is repeated at category level at J37, J40, J41, J42, J45, J47 and J98. The same instruction appears at the I10-I1A hypertensive diseases block, at the I60-I69 cerebrovascular diseases block, and at categories I20, I21, I22, I25, I70, C32, C34, H65, H66, K05, K12 and K13. Sequence the condition first and F17.200 after it.

Does the inpatient or outpatient setting change which code I assign?

No. The code selection is identical in both settings. What changes is the code's function. On an outpatient claim F17.200 supports medical necessity for cessation counseling under CPT 99406 or CPT 99407. On an inpatient claim it is reported as a secondary diagnosis when the admission is for another condition. F17.200 reported as the principal diagnosis groups to MS-DRG 951, Other Factors Influencing Health Status, in MDC 23 under the FY2027 MS-DRG v44 grouper.

What changed for F17.200 in FY2027?

F17.200 is unchanged in the FY2027 update, effective 1 October 2026. The FY2027 codes and tabular addenda make no addition, deletion or revision in category F17. Category F17 received no new or deleted child codes in the FY2026 update, effective 1 October 2025.

Can a nurse or a medical assistant document the smoking status that supports F17.200?

No. Section I.B.14 of the ICD-10-CM Official Guidelines limits code assignment from clinicians other than the patient's provider to a closed list: body mass index, depth of non-pressure chronic ulcers, pressure ulcer stage, coma scale, NIH stroke scale, social determinants of health classified to Chapter 21, laterality, blood alcohol level, underimmunization status and firearm injury intent. Nicotine dependence is not on that list. The patient's provider must document the dependence for F17.200 to be assigned.

Related codes

Codes in the same family as F17.200. Only codes with a published page render as links.

Sibling codes in the F17 family

F17.201: Nicotine dependence, unspecified, in remission.
F17.203: Nicotine dependence unspecified, with withdrawal.
F17.208: Nicotine dependence, unspecified, with other nicotine-induced disorders.
F17.209: Nicotine dependence, unspecified, with unspecified nicotine-induced disorders.
F17.210: Nicotine dependence, cigarettes, uncomplicated.
F17.211: Nicotine dependence, cigarettes, in remission.
F17.213: Nicotine dependence, cigarettes, with withdrawal.
F17.218: Nicotine dependence, cigarettes, with other nicotine-induced disorders.
F17.219: Nicotine dependence, cigarettes, with unspecified nicotine-induced disorders.
F17.220: Nicotine dependence, chewing tobacco, uncomplicated.
F17.221: Nicotine dependence, chewing tobacco, in remission.
F17.223: Nicotine dependence, chewing tobacco, with withdrawal.
F17.228: Nicotine dependence, chewing tobacco, with other nicotine-induced disorders.
F17.229: Nicotine dependence, chewing tobacco, with unspecified nicotine-induced disorders.
F17.290: Nicotine dependence, other tobacco product, uncomplicated.
F17.291: Nicotine dependence, other tobacco product, in remission.
F17.293: Nicotine dependence, other tobacco product, with withdrawal.
F17.298: Nicotine dependence, other tobacco product, with other nicotine-induced disorders.
F17.299: Nicotine dependence, other tobacco product, with unspecified nicotine-induced disorders.

Additional codes to consider

Codes outside the F17 family considered alongside F17.200.

Companion: code alongside when documented

Z71.6: Tobacco abuse counseling, which carries a Use additional instruction to code for nicotine dependence (the F17 codes).
J44.9: Chronic obstructive pulmonary disease, unspecified, reached by the chapter 10 tobacco dependence instruction.
J45.909: Unspecified asthma, uncomplicated, where category J45 carries the same instruction at category level.
I25.10: Atherosclerotic heart disease of native coronary artery without angina pectoris, where category I25 carries a Use additional note for tobacco dependence.
I21.9: Acute myocardial infarction, unspecified, where category I21 carries the same Use additional note.
C34.90: Malignant neoplasm of unspecified part of unspecified bronchus or lung, where category C34 carries the same Use additional note.
O99.330: Smoking (tobacco) complicating pregnancy, unspecified trimester, sequenced ahead of F17.200 under the Use additional note at O99.33.
T65.221-: Toxic effect of tobacco cigarettes, accidental (unintentional), which requires a seventh character, permitted alongside F17.200 by the F17 Excludes2 note.

Consider instead

Z72.0: Tobacco use, where no dependence is documented, carrying an Excludes1 note against the F17.2- codes.
Z87.891: Personal history of nicotine dependence, where the patient no longer uses tobacco, carrying an Excludes1 note against the F17.2- codes.
Z77.22: Contact with and (suspected) exposure to environmental tobacco smoke (acute) (chronic), which carries an Excludes1 note against nicotine dependence (the F17 codes).
F17.210: Nicotine dependence, cigarettes, uncomplicated, where the product is documented.
F17.201: Nicotine dependence, unspecified, in remission, where remission is documented.
F17.203: Nicotine dependence unspecified, with withdrawal, where withdrawal is documented.
U07.0: Vaping-related disorder, for a disorder attributed to electronic cigarette or vaping product use.

Sources

All claims on this page derive from government and professional-standards sources.

National Center for Health Statistics. (2026). International classification of diseases, tenth revision, clinical modification (ICD-10-CM) FY2027 files. https://www.cdc.gov/nchs/icd/icd-10-cm/files.html
Centers for Medicare & Medicaid Services and National Center for Health Statistics. (2026). ICD-10-CM official guidelines for coding and reporting FY2027. https://ftp.cdc.gov/pub/Health_Statistics/NCHS/Publications/ICD10CM/2027/ICD-10-CM-October-1-2026-FY27-Guidelines.pdf
Centers for Medicare & Medicaid Services. (2025). 2026 model software/ICD-10 mappings. https://www.cms.gov/medicare/payment/medicare-advantage-rates-statistics/risk-adjustment/2026-model-software-icd-10-mappings
Centers for Medicare & Medicaid Services. (2026). MS-DRG classifications and software, version 44. https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/ms-drg-classifications-and-software