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ICD-10 Guide
DiagnosesAlcohol Use Disorder In Remission

Alcohol Use Disorder In Remission

ICD-10 Coding for Alcohol Use Disorder in Remission(F10.11, F10.21, F10.91)

PRIMARY SPECIALTYPsychiatry
COMPLEXITYHigh
LAST UPDATED09/15/2025
Sam Tuffun, PT, DPT
Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Alcohol Use Disorder In Remission?
Essential facts and insights about Alcohol Use Disorder in Remission

Key Clinical Considerations:

  • The patient has a history of alcohol use disorder but currently exhibits no significant symptoms of alcohol dependence or abuse.
  • Laboratory findings may include normal liver function tests and absence of alcohol in blood or urine tests.
  • Physical examination findings should show no signs of alcohol-related health issues, such as liver disease or neurological impairment.
  • Imaging studies, if performed, should not reveal any alcohol-related damage to organs.
  • Severity criteria indicate that the patient has not met the criteria for alcohol use disorder for at least 3 months.

Clinical Information

Clinical Criteria & Documentation Requirements

  • Medical records must document the patient's history of alcohol use disorder and current remission status.
  • Specific terminology such as 'in remission' must be used to indicate the current state of the disorder.
  • Documentation examples include: 'Patient has a history of alcohol use disorder, currently in remission as of [date].'
  • Medical necessity documentation should include evidence of treatment and monitoring for alcohol use disorder.
  • Quality measures documentation needs to reflect the patient's progress and adherence to treatment plans.

Coding Guidelines

Usage Guidelines & Examples

  • Use this diagnosis code when the patient has a documented history of alcohol use disorder but is currently asymptomatic.
  • Do NOT use this code if the patient is currently exhibiting symptoms of alcohol use disorder or has not been abstinent for at least 3 months.
  • Similar codes include F10.10 (Alcohol use disorder, unspecified) and F10.20 (Alcohol dependence, unspecified).
  • Common coding errors include misclassifying active alcohol use disorder as in remission; ensure clear documentation of remission status.
  • In complex cases, consider the patient's entire history and current clinical status before selecting the appropriate code.

Code Exclusions

Important Exclusions

  • Conditions explicitly excluded include active alcohol use disorder and alcohol withdrawal syndrome.
  • Alternative codes for excluded conditions include F10.10 for unspecified alcohol use disorder.
  • Conditions are excluded to ensure accurate representation of the patient's current clinical status.
  • Common exclusion mistakes include failing to document the duration of remission or misclassifying active use as remission.
  • Related but distinct conditions include alcohol-induced mood disorder and alcohol-induced psychotic disorder.

Related ICD-10 Codes

Primary Codes
F10.11
Alcohol use disorder, mild, in remission
F10.21
Alcohol use disorder, moderate, in remission
F10.91
Alcohol use disorder, severe, in remission
Differential Codes
F10.10
F10.20
F10.90

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Psychiatry

Specialty Applications

  • This diagnosis applies to individuals with a history of alcohol use disorder who are currently abstinent.
  • Patient populations include adults and adolescents with a history of alcohol use, particularly those in recovery.
  • Clinical settings include outpatient rehabilitation programs, mental health clinics, and primary care settings.
  • Specialty-specific applications are relevant in psychiatry, addiction medicine, and primary care.
  • Treatment contexts include follow-up care after rehabilitation and ongoing monitoring in recovery programs.

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

  • Comprehensive clinical documentation
  • Accurate code selection based on clinical criteria
  • Proper exclusion considerations
  • Specialty-specific coding guidelines

Documentation

Documentation Templates

Template 1

Template: 'Patient diagnosed with alcohol use disorder in remission based on clinical findings and abstinence for [duration].'

Template 2

Template: 'Clinical presentation consistent with alcohol use disorder in remission including absence of withdrawal symptoms.'

Template 3

Template: 'Diagnostic criteria for alcohol use disorder met previously, now in remission as evidenced by [specific findings].'

Template 4

Template: 'Treatment plan initiated for alcohol use disorder with ongoing monitoring for remission status.'

Template 5

Template: 'Follow-up care for alcohol use disorder in remission including regular assessments and support.'

Billing Information

Billing Considerations

  • Ensure proper documentation for billing
  • Verify code specificity requirements
  • Check for any additional codes needed
  • Review payer-specific guidelines

Common Issues

  • Insufficient clinical documentation
  • Incorrect code selection
  • Missing supporting diagnoses
  • Timing and frequency documentation

Frequently Asked Questions

What documentation is required for this diagnosis?

Detailed documentation of the patient's history, current status, and treatment plan is required.

How does this differ from similar diagnoses?

This diagnosis specifically indicates remission, while similar diagnoses may indicate active use or dependence.

What are common billing considerations?

Ensure that the diagnosis aligns with the treatment provided to optimize reimbursement.

What procedures are typically associated?

Related CPT codes may include those for counseling and behavioral therapy.

Are there any quality reporting implications?

Quality measures may include tracking abstinence rates and treatment adherence.