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F17 vs T65.291D

F17 (Nicotine dependence) compared with T65.291D (Toxic effect of other tobacco and nicotine, accidental (unintentional), subsequent encounter), from the official CMS tabular data.

Summary

These codes can be reported together when both conditions are documented, because F17 lists T65.291D under Excludes2, which marks them as distinct conditions.

Official rule
What is different?

The conditions named, billing status and chapter.F17 is “Nicotine dependence”; T65.291D is “Toxic effect of other tobacco and nicotine, accidental (unintentional), subsequent encounter”. F17 is a non-billable header; T65.291D is billable. F17 sits in F01-F99 — Mental, Behavioral and Neurodevelopmental Disorders (F01-F99); T65.291D in S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88).

Registry fact

Can these codes be reported together?

Yes, when both are documented.F17 lists T65.291D under Excludes2: “toxic effect of nicotine (T65.2-)”. Excludes2 marks distinct conditions that may both be reported when both are documented.

Official ruleGuide: Excludes1 vs Excludes2

Is there an Excludes1 relationship?

None.Neither entry carries an Excludes1 note that names the other code. F17 carries 2 Excludes1 notes and T65.291D carries 1 Excludes1 note covering other codes; the side-by-side table quotes them.

Official rule

Is there an Excludes2 relationship?

Yes.F17’s tabular entry: “toxic effect of nicotine (T65.2-)”. The note covers T65.291D.

Official ruleGuide: Excludes1 vs Excludes2

Is one more specific?

Not comparable.The codes sit in different categories; specificity is only comparable within one category.

Is one a parent or header code?

One is a header.F17 is a non-billable header, but T65.291D is not one of its subdivisions.

Registry fact

Are there sequencing instructions?

None.Neither entry carries a Code First or Use Additional Code note that names the other.

Official rule

Are there other coding relationships?

None found.No laterality, encounter-phase, Table of Neoplasms, Table of Drugs and Chemicals, or history-versus-active-disease relationship links these codes.

MedCoder-derived

Official rule: a tabular instructional note or a section of the ICD-10-CM Official Guidelines, quoted as published. Registry fact: the codes’ own published attributes (titles, billable status, position in the hierarchy, code set). MedCoder-derived: a reading MedCoder computes from those facts; it is not itself a rule. How to read the labels

Can these codes be reported together?

Informational

Excludes2 relationship

F17
Nicotine dependence
↔
T65.291D
Toxic effect of other tobacco and nicotine, accidental (unintentional), subsequent encounter

What we found

Yes, when both are documented.F17 carries an Excludes2 note covering T65.291D: “toxic effect of nicotine (T65.2-)”

Excludes2 marks distinct conditions — both may be reported when both are documented.

What to review

Report both only when the documentation supports both conditions; otherwise report the one documented.

Guide: Excludes1 vs Excludes2Check these on a claim

Why it matters

An Excludes2 note means the excluded condition is not part of the code above it, but a patient can have both. Report both when both are documented.

Source / rule

CMS ICD-10-CM tabular instructional notes

Official guidance behind these answers

  • Section I.A.12.b — Excludes2 · applies to: Excludes2

    A type 2 Excludes note represents “Not included here.” An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.

    ICD-10-CM Official Guidelines FY2026

Quoted from the ICD-10-CM Official Guidelines for Coding and Reporting in effect for the release shown. The tabular notes above are the code-level instruction; these sections are the convention that says how such a note is applied. Source document (CMS PDF) · Release and checksum

Side by side

F17Nicotine dependenceT65.291DToxic effect of other tobacco and nicotine, accidental (unintentional), subsequent encounter
Billing statusNon-billable header

Report instead: F17.200, F17.201, F17.203, F17.208, F17.209

Billable
ClassificationF01-F99 — Mental, Behavioral and Neurodevelopmental Disorders (F01-F99)S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88)
DefinitionNicotine dependence is a non-billable ICD-10-CM category code (F17).Toxic effect of other tobacco and nicotine, accidental (unintentional), subsequent encounter is a billable ICD-10-CM diagnosis code (T65.291D).
7th character—The appropriate 7th character is to be added to each code from category T65
Includes—
Toxic effect of other tobacco and nicotine NOS
Excludes1
history of tobacco dependence (Z87.891)
tobacco use NOS (Z72.0)
contact with and (suspected) exposure to toxic substances (Z77.-)
Excludes2
tobacco use (smoking) during pregnancy, childbirth and the puerperium (O99.33-)
toxic effect of nicotine (T65.2-)
nicotine dependence (F17.-)
Use additional code—
code(s):
for all associated manifestations of toxic effect, such as: respiratory conditions due to external agents (J60-J70)
personal history of foreign body fully removed (Z87.821)

Notes are the code’s own tabular entry, quoted as published. A note that names the other code is the one the verdict above rests on.

Edit this comparisonCheck a whole claim

Derived from the official CMS ICD-10-CM tabular data (FY2027). A coding-rule comparison, not billing advice: payer-specific edits and medical-necessity policy are outside its scope. All data sources