ICD-10 Code for History of Smoking: Z87.891

The ICD-10-CM code for a personal history of nicotine dependence, often described as a history of smoking, is Z87.891. It is used when someone previously smoked or had nicotine dependence but no longer does; current tobacco use calls for a different code.

Ingredients

1 current-year ICD-10-CM code set or official coding reference (1 reference)
1 documented patient history describing whether tobacco use is current or former (1 record)
1 encounter note identifying the clinical context and any relevant tobacco-related condition (1 note)

Instructions

Confirm the status. Check the documentation to establish that the person formerly smoked or had nicotine dependence and has stopped. Z87.891 means personal history of nicotine dependence. Do not use it to describe someone who currently smokes or otherwise currently uses tobacco.
Check what the note actually says. Look for the clinician’s documentation of former smoking or former nicotine dependence. Do not infer a former-use history solely from a screening result, an old medication, a diagnosis elsewhere in the record, or a patient’s current symptoms. Follow the documentation and coding rules that apply to your setting.
Distinguish current use from history. If the patient currently uses tobacco, select an appropriate current-use code from the applicable ICD-10-CM category rather than Z87.891. The correct code can depend on the substance and documented circumstances. Do not assume that occasional use, vaping, or smokeless tobacco automatically maps to this history code.
Look for a more specific active diagnosis. If the encounter concerns a current tobacco-related disease, nicotine dependence, or cessation counseling, code the documented condition or service as required. Z87.891 may be relevant as an additional history code when permitted and useful, but it does not replace an active diagnosis or a code for counseling.
Verify the code for the date of service. Search the official ICD-10-CM Alphabetic Index and Tabular List for the applicable fiscal-year release. Confirm the code description, inclusion notes, exclusions, and any sequencing instructions before submitting a claim. Code sets and payer rules can change.
Record the result accurately. When the documentation supports former nicotine dependence and no current use, assign Z87.891 in the appropriate position for the encounter. If the history is unclear or contradictory, request clarification rather than guessing.

Tips

Keep “former” and “current” separate. A person who has quit may have a history code; a person who continues to smoke generally needs a current-use code. The code should reflect the documented status for the encounter.
Do not treat Z87.891 as a smoking-status code for every product. The code description concerns personal history of nicotine dependence. Check the current official index for the documented substance and status, especially for vaping or smokeless tobacco.
Use the full code description. “History of smoking” is common shorthand, but the official description is “Personal history of nicotine dependence.” That distinction helps prevent the code from being used for current nicotine dependence.
Check local requirements. Payers, facilities, and specific programs may have documentation or reporting rules. Verify these separately; a code’s availability does not guarantee coverage or reimbursement.

Serving Suggestions

Use Z87.891 as a historical detail when it is relevant to the reason for the visit, the patient’s risk profile, or care planning and the documentation supports it. It is not a stand-alone substitute for a current tobacco-use diagnosis, a nicotine-dependence diagnosis, or a tobacco-cessation counseling code. Whether it belongs on a particular claim depends on the encounter and applicable coding instructions.

Variations

Former smoker, no documented dependence: Do not automatically choose Z87.891 simply because a note says the person smoked in the past. Check the current Alphabetic Index and Tabular List for the documented circumstance and the code set in effect on the service date; clarify ambiguous wording with the clinician.

Current smoker or tobacco user: Select the applicable current-use code based on the documented substance and circumstances. Z87.891 is not the code for active smoking.

Former use plus an active condition: Code the active condition according to its own documentation and instructions. Add a history code only when relevant, supported, and allowed by the applicable rules.

Storage and Reheating

This is a coding reference, not a food recipe, so there is no cooked dish to store or reheat. Keep patient records and coding references in approved secure systems, following your organization’s privacy, retention, and access policies. For coding decisions, retain or consult the official code-set release that applies to the date of service rather than relying on an undated web snippet.

Frequently Asked Questions

What is the ICD-10 code for a history of smoking?
Z87.891 is the ICD-10-CM code for personal history of nicotine dependence. Confirm that the record supports former use and that the code is appropriate for the date of service and clinical context.

Does Z87.891 mean the patient currently smokes?
No. It is a history code, not a code for active smoking or current nicotine dependence. Current use should be coded from the applicable current-use category based on the documentation.

Can I use Z87.891 for anyone who smoked in the past?
Not automatically. The official descriptor is personal history of nicotine dependence. If the note only mentions past smoking without establishing the relevant history, consult the current index and tabular instructions or seek clarification.

Is Z87.891 the same as a tobacco-cessation counseling code?
No. Z87.891 describes a personal history. Counseling services have separate coding considerations, and the appropriate code depends on what service was provided and documented.

Can Z87.891 be reported with an active tobacco-related disease?
It may be appropriate as an additional history code when relevant and permitted, but it does not replace coding the active disease. Follow the tabular instructions, sequencing rules, payer requirements, and documentation for that encounter.

Should I use this code for vaping or smokeless tobacco?
Do not assume so. Check the official current-year ICD-10-CM index and tabular notes for the specific substance and whether use is current or historical. If the record is unclear, ask for clarification.

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