Z77.22 Contact with and (suspected) exposure to environmental tobacco smoke (acute) (chronic)

Billable ICD-10-CM code, FY2026.

Applicable to

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

Excludes1 (never code together)

• nicotine dependence (F17.-)
• tobacco use (Z72.0)

Excludes2 (not included here)

• occupational exposure to environmental tobacco smoke (Z57.31)

Applies from Z77 Other contact with and (suspected) exposures hazardous to health

Includes

• contact with and (suspected) exposures to potential hazards to health

Excludes2 (not included here)

• 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)

MS-DRG index

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

Approximate ICD-9-CM (GEMs)

• V15.89 Other specified personal history presenting hazards to health (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 Z77.22

Back-references to Z77.22

• Use Additional: C07 Malignant neoplasm of parotid gland ("exposure to environmental tobacco smoke (Z77.22)")
• Use Additional: C08 Malignant neoplasm of other and unspecified major salivary glands ("exposure to environmental tobacco smoke (Z77.22)")
• Use Additional: C09 Malignant neoplasm of tonsil ("exposure to environmental tobacco smoke (Z77.22)")
• Use Additional: C10 Malignant neoplasm of oropharynx ("exposure to environmental tobacco smoke (Z77.22)")
• Use Additional: C11 Malignant neoplasm of nasopharynx ("exposure to environmental tobacco smoke (Z77.22)")
• Use Additional: C12 Malignant neoplasm of pyriform sinus ("exposure to environmental tobacco smoke (Z77.22)")
• Use Additional: C13 Malignant neoplasm of hypopharynx ("exposure to environmental tobacco smoke (Z77.22)")
• Use Additional: C14 Malignant neoplasm of other and ill-defined sites in the lip, oral cavity and pharynx ("exposure to environmental tobacco smoke (Z77.22)")
• Use Additional: C32 Malignant neoplasm of larynx ("exposure to environmental tobacco smoke (Z77.22)")
• Use Additional: C33 Malignant neoplasm of trachea ("exposure to environmental tobacco smoke (Z77.22)")
• Use Additional: C34 Malignant neoplasm of bronchus and lung ("exposure to environmental tobacco smoke (Z77.22)")
• Use Additional: C39 Malignant neoplasm of other and ill-defined sites in the respiratory system and intrathoracic organs ("exposure to environmental tobacco smoke (Z77.22)")
• Use Additional: D00.0 Carcinoma in situ of lip, oral cavity and pharynx ("exposure to environmental tobacco smoke (Z77.22)")
• Use Additional: D02 Carcinoma in situ of middle ear and respiratory system ("exposure to environmental tobacco smoke (Z77.22)")
• Use Additional: G31.84 Mild cognitive impairment of uncertain or unknown etiology ("exposure to environmental tobacco smoke (Z77.22)")
• Use Additional: H65 Nonsuppurative otitis media ("exposure to environmental tobacco smoke (Z77.22)")
• Use Additional: H66 Suppurative and unspecified otitis media ("exposure to environmental tobacco smoke (Z77.22)")
• Use Additional: I20 Angina pectoris ("exposure to environmental tobacco smoke (Z77.22)")
• Use Additional: I21 Acute myocardial infarction ("exposure to environmental tobacco smoke (Z77.22)")
• Use Additional: I22 Subsequent ST elevation (STEMI) and non-ST elevation (NSTEMI) myocardial infarction ("exposure to environmental tobacco smoke (Z77.22)")
• Use Additional: I25 Chronic ischemic heart disease ("exposure to environmental tobacco smoke (Z77.22)")
• Use Additional: I70 Atherosclerosis ("exposure to environmental tobacco smoke (Z77.22)")
• Use Additional: J37 Chronic laryngitis and laryngotracheitis ("exposure to environmental tobacco smoke (Z77.22)")
• Use Additional: J40 Bronchitis, not specified as acute or chronic ("exposure to environmental tobacco smoke (Z77.22)")
• Use Additional: J41 Simple and mucopurulent chronic bronchitis ("exposure to environmental tobacco smoke (Z77.22)")
• Use Additional: J42 Unspecified chronic bronchitis ("exposure to environmental tobacco smoke (Z77.22)")
• Use Additional: J45 Asthma ("exposure to environmental tobacco smoke (Z77.22)")
• Use Additional: J47 Bronchiectasis ("exposure to environmental tobacco smoke (Z77.22)")
• Use Additional: J81 Pulmonary edema ("exposure to environmental tobacco smoke (Z77.22)")
• Use Additional: J98 Other respiratory disorders ("exposure to environmental tobacco smoke (Z77.22)")
• Use Additional: K05 Gingivitis and periodontal diseases ("exposure to environmental tobacco smoke (Z77.22)")
• Use Additional: K11 Diseases of salivary glands ("exposure to environmental tobacco smoke (Z77.22)")
• Use Additional: K12 Stomatitis and related lesions ("exposure to environmental tobacco smoke (Z77.22)")
• Use Additional: K13 Other diseases of lip and oral mucosa ("exposure to environmental tobacco smoke (Z77.22)")
• Use Additional: K14 Diseases of tongue ("exposure to environmental tobacco smoke (Z77.22)")
• Type 2 Excludes: P96.81 Exposure to (parental) (environmental) tobacco smoke in the perinatal period ("exposure to environmental tobacco smoke after the perinatal period (Z77.22)")
• Use Additional: T65.22 Toxic effect of tobacco cigarettes ("code for exposure to second hand tobacco smoke (Z57.31, Z77.22)")
• Type 2 Excludes: Z57.31 Occupational exposure to environmental tobacco smoke ("exposure to environmental tobacco smoke (Z77.22)")
• Use Additional: Z85 Personal history of malignant neoplasm ("exposure to environmental tobacco smoke (Z77.22)")

Back-references to Z77

• Type 2 Excludes: 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.-)")
• Type 1 Excludes: Z03 Encounter for medical observation for suspected diseases and conditions ruled out ("contact with and (suspected) exposures hazardous to health (Z77.-)")
• 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: Z91 Personal risk factors, not elsewhere classified ("contact with and (suspected) exposures hazardous to health (Z77.-)")

Diagnosis Index entries for Z77.22

• Exposure (to) › environmental tobacco smoke (acute) (chronic)
• Exposure (to) › second hand tobacco smoke (acute) (chronic)
• Passive › smoking
• Second hand tobacco smoke exposure (acute) (chronic)
• Smoking › passive
• Exposure (to) › smoke › tobacco, second hand

Nearby codes

• Z77.122 Contact with and (suspected) exposure to noise
• Z77.123 Contact with and (suspected) exposure to radon and other naturally occurring radiation
• Z77.128 Contact with and (suspected) exposure to other hazards in the physical environment
• Z77.2 Contact with and (suspected) exposure to other hazardous substances
• Z77.21 Contact with and (suspected) exposure to potentially hazardous body fluids
• Z77.22 Contact with and (suspected) exposure to environmental tobacco smoke (acute) (chronic) (this code)
• Z77.29 Contact with and (suspected) exposure to other hazardous substances
• Z77.3 Contact with and (suspected) exposure to war theater
• Z77.31 Contact with and (suspected) exposure to Gulf War theater
• Z77.39 Contact with and (suspected) exposure to other war theater
• Z77.9 Other contact with and (suspected) exposures hazardous to health