ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesF11.13

F11.13

Billable

Opioid abuse with withdrawal

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

Code Description

ICD-10 F11.13 is a billable code used to indicate a diagnosis of opioid abuse with withdrawal.

Key Diagnostic Point:

Opioid abuse with withdrawal refers to a pattern of opioid use that leads to significant impairment or distress, characterized by the development of withdrawal symptoms when the substance is reduced or discontinued. Opioids, which include prescription medications like oxycodone and illicit drugs like heroin, can lead to physical dependence and addiction. Withdrawal symptoms may include anxiety, muscle aches, insomnia, sweating, nausea, and vomiting. The diagnosis of opioid abuse with withdrawal is made when the individual exhibits a compulsive pattern of opioid use despite negative consequences, and experiences withdrawal symptoms upon cessation. Treatment often involves a combination of behavioral therapies and medications, such as methadone or buprenorphine, to manage withdrawal symptoms and reduce cravings. Understanding the complexities of opioid use disorder is crucial for effective treatment and recovery, as it often coexists with other mental health disorders, necessitating a comprehensive approach to care.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between opioid abuse and dependence
  • Identifying withdrawal symptoms accurately
  • Documenting the severity and duration of opioid use
  • Co-occurring mental health disorders

Audit Risk Factors

  • Inadequate documentation of withdrawal symptoms
  • Failure to document the history of opioid use
  • Misclassification of opioid use disorder severity
  • Lack of evidence for treatment plans

Specialty Focus

Medical Specialties

Addiction Medicine

Documentation Requirements

Comprehensive assessment of substance use history, withdrawal symptoms, and treatment plans.

Common Clinical Scenarios

Patients presenting with withdrawal symptoms after cessation of opioid use, or those seeking treatment for opioid use disorder.

Billing Considerations

Ensure accurate documentation of the patient's substance use history and any co-occurring mental health conditions.

Psychiatry

Documentation Requirements

Detailed mental health evaluations, including assessment of co-occurring disorders and treatment response.

Common Clinical Scenarios

Patients with opioid use disorder presenting with anxiety, depression, or other psychiatric symptoms.

Billing Considerations

Document the interplay between opioid use and mental health symptoms to support accurate coding.

Coding Guidelines

Inclusion Criteria

Use F11.13 When
  • According to ICD
  • 10 guidelines, F11
  • 13 should be used when there is clear documentation of opioid abuse and the presence of withdrawal symptoms
  • It is essential to differentiate this from other substance use disorders and to ensure that the withdrawal symptoms are well
  • documented

Exclusion Criteria

Do NOT use F11.13 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

H0020CPT Code

Behavioral health counseling

Clinical Scenario

Used for patients receiving counseling as part of their treatment for opioid abuse.

Documentation Requirements

Document the nature of counseling and its relation to opioid use disorder.

Specialty Considerations

Ensure that the counseling aligns with the treatment plan for opioid abuse.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of opioid use disorders, including the differentiation between abuse and dependence, which aids in better treatment planning and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of opioid use disorders, including the differentiation between abuse and dependence, which aids in better treatment planning and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of opioid use disorders, including the differentiation between abuse and dependence, which aids in better treatment planning and resource allocation.

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 withdrawal?

Key symptoms of opioid withdrawal include anxiety, muscle aches, insomnia, sweating, nausea, vomiting, and diarrhea. These symptoms can vary in intensity and duration depending on the level of opioid dependence.