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Required Documentation Elements To support Z87.891 on a claim, the encounter note should include: Explicit provider statement that the patient is a former tobacco user or has a personal history of nicotine dependence Confirmation of current non-use patient no longer smokes or tobacco-free for X years is sufficient Prior dependence context documentation that the patient previously met dependence criteria (e.g., pack-year history, prior cessation treatment, prior F17.x diagnosis) No active treatment goal counseling or cessation medications should not be documented as current clinical goals when using Z87.891 The AHIMA Coding Clinic and AAPC both emphasize that Z codes in Chapter 21 require provider attestation, not coder inference