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ICD-10 Guide
ICD-10 CodesF11.122

F11.122

Billable

Opioid abuse with intoxication with perceptual disturbance

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 F11.122 is a billable code used to indicate a diagnosis of opioid abuse with intoxication with perceptual disturbance.

Key Diagnostic Point:

F11.122 refers to a specific diagnosis of opioid abuse characterized by the presence of intoxication and perceptual disturbances. Opioid abuse is a significant public health issue, often leading to addiction, which is defined as a chronic, relapsing disorder characterized by compulsive drug seeking, continued use despite harmful consequences, and long-lasting changes in the brain. Intoxication with opioids can lead to various symptoms, including euphoria, drowsiness, and altered mental status. Perceptual disturbances may manifest as hallucinations or altered sensory perceptions, which can complicate the clinical picture. This diagnosis is crucial for treatment planning, as it indicates the need for immediate intervention to address both the substance use disorder and the acute effects of intoxication. Treatment may involve detoxification, behavioral therapies, and medication-assisted treatment (MAT) to manage withdrawal symptoms and reduce cravings. Understanding the complexities of opioid abuse and its effects on perception is essential for healthcare providers to deliver effective care and support recovery.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between intoxication and withdrawal symptoms
  • Identifying perceptual disturbances accurately
  • Documenting the severity of opioid abuse
  • Understanding the nuances of substance use disorder classifications

Audit Risk Factors

  • Inadequate documentation of perceptual disturbances
  • Failure to specify the type of opioid involved
  • Lack of evidence for the severity of abuse
  • Inconsistent coding with clinical notes

Specialty Focus

Medical Specialties

Addiction Medicine

Documentation Requirements

Comprehensive assessment of substance use history, current intoxication symptoms, and mental health evaluation.

Common Clinical Scenarios

Patients presenting with acute intoxication, requiring immediate intervention and stabilization.

Billing Considerations

Ensure that all aspects of the patient's substance use history are documented, including previous treatment attempts and co-occurring mental health disorders.

Psychiatry

Documentation Requirements

Detailed mental status examination and assessment of perceptual disturbances.

Common Clinical Scenarios

Patients with a history of opioid use presenting with hallucinations or altered perceptions.

Billing Considerations

Document the impact of opioid use on the patient's mental health and any co-existing psychiatric conditions.

Coding Guidelines

Inclusion Criteria

Use F11.122 When
  • According to ICD
  • 10 guidelines, F11
  • 122 should be used when there is clear documentation of opioid abuse with specific mention of perceptual disturbances
  • It is essential to differentiate this from other substance use disorders and ensure that the diagnosis aligns with clinical findings

Exclusion Criteria

Do NOT use F11.122 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

H0031CPT Code

Mental health assessment

Clinical Scenario

Used when assessing a patient for opioid abuse and intoxication.

Documentation Requirements

Document the assessment findings, including any perceptual disturbances.

Specialty Considerations

Addiction specialists should ensure thorough documentation of substance use history.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of substance use disorders, including the differentiation of intoxication types and associated symptoms, which enhances the accuracy of treatment planning and reimbursement.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of substance use disorders, including the differentiation of intoxication types and associated symptoms, which enhances the accuracy of treatment planning and reimbursement.

Reimbursement & Billing Impact

reimbursement.

Resources

Clinical References

  • •
    Substance Abuse and Mental Health Services Administration (SAMHSA)

Coding & Billing References

  • •
    Substance Abuse and Mental Health Services Administration (SAMHSA)

Frequently Asked Questions

What are the key symptoms of opioid intoxication with perceptual disturbance?

Key symptoms include altered mental status, euphoria, drowsiness, and perceptual disturbances such as hallucinations or altered sensory perceptions.