Z57.31 Occupational exposure to environmental tobacco smoke

Billable ICD-10-CM code, FY2026. Exempt from present-on-admission (POA) reporting.

Excludes2 (not included here)

• exposure to environmental tobacco smoke (Z77.22)

MS-DRG index

Defines the logic of DRG(s) 951 in MDC 23.

Approximate ICD-9-CM (GEMs)

• V62.1 Adverse effects of work environment (approximate)

Medicare Code Edits (MCE v43.1 (April 2026))

• Unacceptable principal diagnosis: These codes describe a circumstance which influences care but is not a current illness or injury, or capture only an underlying condition, and are unacceptable as principal diagnosis.

Code annotations containing back-references to Z57.31

Back-references to Z57.31

• Use Additional: C07 Malignant neoplasm of parotid gland ("occupational exposure to environmental tobacco smoke (Z57.31)")
• Use Additional: C08 Malignant neoplasm of other and unspecified major salivary glands ("occupational exposure to environmental tobacco smoke (Z57.31)")
• Use Additional: C09 Malignant neoplasm of tonsil ("occupational exposure to environmental tobacco smoke (Z57.31)")
• Use Additional: C10 Malignant neoplasm of oropharynx ("occupational exposure to environmental tobacco smoke (Z57.31)")
• Use Additional: C11 Malignant neoplasm of nasopharynx ("occupational exposure to environmental tobacco smoke (Z57.31)")
• Use Additional: C12 Malignant neoplasm of pyriform sinus ("occupational exposure to environmental tobacco smoke (Z57.31)")
• Use Additional: C13 Malignant neoplasm of hypopharynx ("occupational exposure to environmental tobacco smoke (Z57.31)")
• Use Additional: C14 Malignant neoplasm of other and ill-defined sites in the lip, oral cavity and pharynx ("occupational exposure to environmental tobacco smoke (Z57.31)")
• Use Additional: C32 Malignant neoplasm of larynx ("occupational exposure to environmental tobacco smoke (Z57.31)")
• Use Additional: C33 Malignant neoplasm of trachea ("occupational exposure to environmental tobacco smoke (Z57.31)")
• Use Additional: C34 Malignant neoplasm of bronchus and lung ("occupational exposure to environmental tobacco smoke (Z57.31)")
• Use Additional: C39 Malignant neoplasm of other and ill-defined sites in the respiratory system and intrathoracic organs ("occupational exposure to environmental tobacco smoke (Z57.31)")
• Use Additional: D00.0 Carcinoma in situ of lip, oral cavity and pharynx ("occupational exposure to environmental tobacco smoke (Z57.31)")
• Use Additional: D02 Carcinoma in situ of middle ear and respiratory system ("occupational exposure to environmental tobacco smoke (Z57.31)")
• Use Additional: G31.84 Mild cognitive impairment of uncertain or unknown etiology ("occupational exposure to environmental tobacco smoke (Z57.31)")
• Use Additional: H65 Nonsuppurative otitis media ("occupational exposure to environmental tobacco smoke (Z57.31)")
• Use Additional: H66 Suppurative and unspecified otitis media ("occupational exposure to environmental tobacco smoke (Z57.31)")
• Use Additional: I20 Angina pectoris ("occupational exposure to environmental tobacco smoke (Z57.31)")
• Use Additional: I21 Acute myocardial infarction ("occupational exposure to environmental tobacco smoke (Z57.31)")
• Use Additional: I22 Subsequent ST elevation (STEMI) and non-ST elevation (NSTEMI) myocardial infarction ("occupational exposure to environmental tobacco smoke (Z57.31)")
• Use Additional: I25 Chronic ischemic heart disease ("occupational exposure to environmental tobacco smoke (Z57.31)")
• Use Additional: I70 Atherosclerosis ("occupational exposure to environmental tobacco smoke (Z57.31)")
• Use Additional: J37 Chronic laryngitis and laryngotracheitis ("occupational exposure to environmental tobacco smoke (Z57.31)")
• Use Additional: J40 Bronchitis, not specified as acute or chronic ("occupational exposure to environmental tobacco smoke (Z57.31)")
• Use Additional: J41 Simple and mucopurulent chronic bronchitis ("occupational exposure to environmental tobacco smoke (Z57.31)")
• Use Additional: J42 Unspecified chronic bronchitis ("occupational exposure to environmental tobacco smoke (Z57.31)")
• Use Additional: J45 Asthma ("occupational exposure to environmental tobacco smoke (Z57.31)")
• Use Additional: J47 Bronchiectasis ("occupational exposure to environmental tobacco smoke (Z57.31)")
• Use Additional: J81 Pulmonary edema ("occupational exposure to environmental tobacco smoke (Z57.31)")
• Use Additional: J98 Other respiratory disorders ("occupational exposure to environmental tobacco smoke (Z57.31)")
• Use Additional: K05 Gingivitis and periodontal diseases ("occupational exposure to environmental tobacco smoke (Z57.31)")
• Use Additional: K11 Diseases of salivary glands ("occupational exposure to environmental tobacco smoke (Z57.31)")
• Use Additional: K12 Stomatitis and related lesions ("occupational exposure to environmental tobacco smoke (Z57.31)")
• Use Additional: K13 Other diseases of lip and oral mucosa ("occupational exposure to environmental tobacco smoke (Z57.31)")
• Use Additional: K14 Diseases of tongue ("occupational exposure to environmental tobacco smoke (Z57.31)")
• Use Additional: T65.22 Toxic effect of tobacco cigarettes ("code for exposure to second hand tobacco smoke (Z57.31, Z77.22)")
• Type 2 Excludes: Z77.22 Contact with and (suspected) exposure to environmental tobacco smoke (acute) (chronic) ("occupational exposure to environmental tobacco smoke (Z57.31)")
• Use Additional: Z85 Personal history of malignant neoplasm ("occupational exposure to environmental tobacco smoke (Z57.31)")

Back-references to Z57

• Type 1 Excludes: Z13.88 Encounter for screening for disorder due to exposure to contaminants ("those exposed to contaminants without suspected disorders (Z57.-, Z77.-)")
• Type 2 Excludes: Z56 Problems related to employment and unemployment ("occupational exposure to risk factors (Z57.-)")
• Type 2 Excludes: Z58 Problems related to physical environment ("occupational exposure (Z57.-)")
• Type 2 Excludes: Z72 Problems related to lifestyle ("problems related to socioeconomic and psychosocial circumstances (Z55-Z65)")
• Type 2 Excludes: Z73 Problems related to life management difficulty ("problems related to socioeconomic and psychosocial circumstances (Z55-Z65)")
• Type 2 Excludes: Z77 Other contact with and (suspected) exposures hazardous to health ("occupational exposure to risk factors (Z57.-)")
• Type 2 Excludes: Z91 Personal risk factors, not elsewhere classified ("occupational exposure to risk factors (Z57.-)")

Diagnosis Index entries for Z57.31

• Exposure (to) › occupational › environmental tobacco smoke

Nearby codes

• Z57 Occupational exposure to risk factors
• Z57.0 Occupational exposure to noise
• Z57.1 Occupational exposure to radiation
• Z57.2 Occupational exposure to dust
• Z57.3 Occupational exposure to other air contaminants
• Z57.31 Occupational exposure to environmental tobacco smoke (this code)
• Z57.39 Occupational exposure to other air contaminants
• Z57.4 Occupational exposure to toxic agents in agriculture
• Z57.5 Occupational exposure to toxic agents in other industries
• Z57.6 Occupational exposure to extreme temperature
• Z57.7 Occupational exposure to vibration