572 Substance-Related and Addictive Disorders
Specify if:
On maintenance therapy: The individual is taking a long-term maintenance medica-
tion, such as nicotine replacement medication, and no criteria for tobacco use disorder
have been met for that class of medication (except tolerance to, or withdrawal from,
the nicotine replacement medication).
In a controlled environment:  This additional specifier is used if the individual is in an
environment where access to tobacco is restricted.
Coding based on current severity:  Note for ICD-10-CM codes: If a tobacco withdrawal or
tobacco-induced sleep disorder is also present, do not use the codes below for tobacco use
disorder. Instead, the comorbid tobacco use disorder is indicated in the 4th character of the
tobacco-induced disorder code (see the coding note for tobacco withdrawal or tobacco-
induced sleep disorder). For example, if ther e is comorbid tobacco-induced sleep disorder and
tobacco use disorder, only the tobacco-induced sleep disorder code is given, with the 4th char-
acter indicating whether the comorbid tobacco use disorder is moderate or severe: F17.208
for moderate or severe tobacco use disorder with tobacco-induced sleep disorder. It is not per-
missible to code a comorbid mild tobacco use disorder with a tobacco-induced sleep disorder.
Specify current severity:
305.1 (Z72.0) Mild:  Presence of 2–3 symptoms.
305.1 (F17.200) Moderate: Presence of 4–5 symptoms.
305.1 (F17.200) Severe:  Presence of 6 or more symptoms.
Specifiers
“On maintenance therapy” applies as a further specifier to individuals being maintained on
other tobacco cessation me dication (e.g., bupropio n, varenicline) and as  a further specifier of