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O99.33 vs Z72.0

O99.33 (Tobacco use disorder complicating pregnancy, childbirth, and the puerperium) compared with Z72.0 (Tobacco use), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.

Can these codes be reported together?

No — do not report together. Z72.0 carries an Excludes1 note covering O99.33: “tobacco use during pregnancy (O99.33-)”

Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Side by side

O99.33Tobacco use disorder complicating pregnancy, childbirth, and the puerperiumZ72.0Tobacco use
Billing statusNon-billable header

Report instead: O99.330, O99.331, O99.332, O99.333, O99.334

Billable
ClassificationO00-O9A — Pregnancy, Childbirth and the Puerperium (O00-O9A)Z00-Z99 — Factors Influencing Health Status and Contact with Health Services (Z00-Z99)
DefinitionTobacco use disorder complicating pregnancy, childbirth, and the puerperium is a non-billable ICD-10-CM category code (O99.33).Tobacco use is a billable ICD-10-CM diagnosis code (Z72.0).
Includes
conditions which complicate the pregnant state, are aggravated by the pregnancy or are a main reason for obstetric care
Smoking complicating pregnancy, childbirth, and the puerperium
Tobacco use NOS
Use additional code
code from category F17 to identify type of tobacco nicotine dependence
code to identify specific condition

Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources