2027 ICD-10-CM Diagnosis Code Z77.22Contact with and (suspected) exposure to environmental tobacco smoke (acute) (chronic)

ICD-10-CM Codes›Z00–Z99›Z77-Z99›suspected

ICD-10-CM Z77.22
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

Z77.22 is a billable ICD-10-CM diagnosis code for contact with and (suspected) exposure to environmental tobacco smoke (acute) (chronic). It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 951. The code is not accepted as a principal diagnosis by the Medicare Code Editor. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Other specified status.

Code Identity

ICD-10-CM Code
Z77.22
Billable Status
Yes — Valid for Submission
Code Describes
Contact with and (suspected) exposure to environmental tobacco smoke (acute) (chronic)
Short Description
Cntct w and expsr to environ tobacco smoke (acute) (chronic)
Parent Code
Z77.2
Contact with and (suspected) exposure to other hazardous substances

Code Classification

ChapterZ00–Z99Factors influencing health status and contact with health services
SectionZ77-Z99Persons with potential health hazards related to family and personal history and certain conditions influencing health status
CategorysuspectedOther contact with and exposures hazardous to health (Z77)
This CodeZ77.22Contact with and (suspected) exposure to environmental tobacco smoke (acute) (chronic)

Code EditsBilling

Medicare Code Editor checks that affect claim validity for Z77.22.

Unacceptable principal diagnosis
There are selected codes that describe a circumstance which influences an individual's health status but not a current illness or injury, or codes that are not specific manifestations but may be due to an underlying cause. These codes are considered unacceptable as a principal diagnosis.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Alveolar macrophage pneumonia
  • Alveolar macrophage pneumonia caused by cigarette smoke
  • Chronic obstructive pulmonary disease caused by cigarette smoke
  • Exposed to tobacco smoke at home
  • Exposed to tobacco smoke at work
  • Exposed to tobacco smoke in public places
  • Exposure to second hand tobacco smoke
  • History of exposure to second hand smoke
  • Non-smoker's second hand smoke syndrome
  • Passive smoker
  • Poisoning caused by smoke
  • Secondary alveolar macrophage pneumonia
  • Smoker in home
  • Toxic effect of secondary tobacco exposure

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to Z77.22: its own notes plus those printed at Z77, block Z77-Z99, and Chapter 21. A note printed at a category, block or chapter applies to every code under it.

Includes

Further defines, or gives examples of, the content of the category.

From Z77 Other contact with and (suspected) exposures hazardous to health applies to 31 codes
  • contact with and (suspected) exposures to potential hazards to health

Applicable To

Conditions this code is used for: synonyms of the title or, for "other specified" codes, the conditions assigned to it. The list is not exhaustive.

  • Exposure to second hand tobacco smoke (acute) (chronic)
  • Passive smoking (acute) (chronic)

Excludes1

Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

On Z77.22 itself
  • occupational exposure to environmental tobacco smoke (Z57.31)
From Z77 Other contact with and (suspected) exposures hazardous to health applies to 31 codes
  • 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)

Code Also

A second code may be needed to fully describe the condition; the note gives no sequencing direction.

From Block Z77-Z99 Persons with potential health hazards related to family and personal history and certain conditions influencing health status applies to 567 codes
  • any follow-up examination (Z08-Z09)

Notes

General instructions on how these codes are used.

From Chapter 21 (Z00-Z99) Factors influencing health status and contact with health services applies to 1,425 codes
  • Z codes represent reasons for encounters. A corresponding procedure code must accompany a Z code if a procedure is performed. Categories Z00-Z99 are provided for occasions when circumstances other than a disease, injury or external cause classifiable to categories A00-Y89 are recorded as 'diagnoses' or 'problems'. This can arise in two main ways:
  • (a) When a person who may or may not be sick encounters the health services for some specific purpose, such as to receive limited care or service for a current condition, to donate an organ or tissue, to receive prophylactic vaccination (immunization), or to discuss a problem which is in itself not a disease or injury.
  • (b) When some circumstance or problem is present which influences the person's health status but is not in itself a current illness or injury.

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name Z77.22, its category, or a range that includes it.

Excludes1 3

These codes carry an Excludes1 note naming Z77.22: they are not reported together with it, unless the two conditions are unrelated.

  • Block T51-T65 Toxic effects of substances chiefly nonmedicinal as to source
    contact with and (suspected) exposure to toxic substances (Z77.-) names Z77.-, which includes this code
  • Z03 Encounter for medical observation for suspected diseases and conditions ruled out
    contact with and (suspected) exposures hazardous to health (Z77.-) names Z77.-, which includes this code
  • Z13.88 Encounter for screening for disorder due to exposure to contaminants
    those exposed to contaminants without suspected disorders (Z57.-, Z77.-) names Z77.-, which includes this code

Excludes2 4

These codes carry an Excludes2 note naming Z77.22: its condition is not part of those codes, and both may be reported when the patient has both.

  • P96.81 Exposure to (parental) (environmental) tobacco smoke in the perinatal period
    exposure to environmental tobacco smoke after the perinatal period (Z77.22)
  • Z57.31 Occupational exposure to environmental tobacco smoke
    exposure to environmental tobacco smoke (Z77.22)
  • P04 Newborn affected by noxious substances transmitted via placenta or breast milk
    newborn in contact with and (suspected) exposures hazardous to health not transmitted via placenta or breast milk (Z77.-) names Z77.-, which includes this code
  • Z91 Personal risk factors, not elsewhere classified
    contact with and (suspected) exposures hazardous to health (Z77.-) names Z77.-, which includes this code

Use Additional Code 40

These codes say to use an additional code from the note, and Z77.22 is one of the codes named.

  • C07 Malignant neoplasm of parotid gland
    exposure to environmental tobacco smoke (Z77.22)
  • C08 Malignant neoplasm of other and unspecified major salivary glands
    exposure to environmental tobacco smoke (Z77.22)
  • C09 Malignant neoplasm of tonsil
    exposure to environmental tobacco smoke (Z77.22)
  • C10 Malignant neoplasm of oropharynx
    exposure to environmental tobacco smoke (Z77.22)
  • C11 Malignant neoplasm of nasopharynx
    exposure to environmental tobacco smoke (Z77.22)
  • C12 Malignant neoplasm of pyriform sinus
    exposure to environmental tobacco smoke (Z77.22)
  • C13 Malignant neoplasm of hypopharynx
    exposure to environmental tobacco smoke (Z77.22)
  • C14 Malignant neoplasm of other and ill-defined sites in the lip, oral cavity and pharynx
    exposure to environmental tobacco smoke (Z77.22)
  • C32 Malignant neoplasm of larynx
    exposure to environmental tobacco smoke (Z77.22)
  • C33 Malignant neoplasm of trachea
    exposure to environmental tobacco smoke (Z77.22)
  • C34 Malignant neoplasm of bronchus and lung
    exposure to environmental tobacco smoke (Z77.22)
  • C39 Malignant neoplasm of other and ill-defined sites in the respiratory system and intrathoracic organs
    exposure to environmental tobacco smoke (Z77.22)
  • D00.0 Carcinoma in situ of lip, oral cavity and pharynx
    exposure to environmental tobacco smoke (Z77.22)
  • D02 Carcinoma in situ of middle ear and respiratory system
    exposure to environmental tobacco smoke (Z77.22)
  • G31.84 Mild cognitive impairment of uncertain or unknown etiology
    exposure to environmental tobacco smoke (Z77.22)

25 more Use Additional Code notes name this code. Browse all Use Additional Code notes.

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

External Cause of Injuries IndexGuidance

References for this code in the External Cause of Injuries Index; each main term links to its index entry.

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR FAC025
Other specified status
Default principal diagnosis: inpatient No · outpatient Yes

Patient EducationClinical

Secondhand Smoke

Secondhand smoke is a mixture of the smoke that comes from the burning end of a cigarette, cigar, or pipe, and the smoke breathed out by the smoker. It contains more than 7,000 chemicals. Hundreds of those chemicals are toxic and about 70 can cause cancer.

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert Z77.22 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
V15.89 Hx-health hazards NEC
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About Z77.22Overview

Is Z77.22 a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report contact with and (suspected) exposure to environmental tobacco smoke (acute) (chronic) on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does Z77.22 group to?

On inpatient claims, contact with and (suspected) exposure to environmental tobacco smoke (acute) (chronic) maps to MS-DRG 951 (other Factors Influencing Health Status), which carries a relative weight of 0.5574. Higher weights mean higher Medicare reimbursement.

Can Z77.22 be a principal diagnosis?

No. The Medicare Code Editor rejects this code as a principal diagnosis because contact with and (suspected) exposure to environmental tobacco smoke (acute) (chronic) describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.

Can Z77.22 be reported with a code from F17?

Not as a rule. The Excludes1 note on Z77.22 lists "nicotine dependence (F17.-)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).

What is the ICD-9 equivalent of Z77.22?

Under the General Equivalence Mappings, contact with and (suspected) exposure to environmental tobacco smoke (acute) (chronic) converts to ICD-9-CM V15.89 (hx-health hazards NEC). The mapping is approximate, so confirm the match fits the documentation.