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When documentation supports both, ICD-10-CM guidelines require assigning only F11.20

The rapid proliferation of the availability of ENDS in many countries often results in a delayed approach to e-cigarette legislation and the struggle to find a balance between caution and adaptation

Importantly, these changes are further elevated in lung cancers or pre-cancers (abnormal cells or tissue that have the potential to develop into cancer), when compared to the normal lung tissue, supporting the idea that the epigenetic changes associated with smoking allow cells to grow more quickly

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