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ICD-10 Guide
ICD-10 CodesF11.14

F11.14

Billable

Opioid abuse with opioid-induced mood disorder

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

Code Description

ICD-10 F11.14 is a billable code used to indicate a diagnosis of opioid abuse with opioid-induced mood disorder.

Key Diagnostic Point:

F11.14 refers to a condition characterized by the abuse of opioids, which leads to a mood disorder as a direct consequence of opioid use. Opioid abuse is defined as the recurrent use of opioids despite significant adverse consequences, including health issues, social problems, and legal difficulties. The mood disorder associated with this code can manifest as depression, anxiety, or other mood disturbances that arise during or after opioid use. Clinically, patients may present with symptoms such as irritability, mood swings, and depressive episodes, which can complicate treatment and recovery. The diagnosis requires a thorough assessment of the patient's substance use history, mental health status, and the impact of opioids on their mood. Treatment often involves a combination of behavioral therapies, medication-assisted treatment (MAT), and support programs aimed at addressing both the substance use disorder and the mood disorder. Accurate coding is essential for appropriate treatment planning and reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between opioid-induced mood disorder and primary mood disorders.
  • Need for comprehensive documentation of substance use history.
  • Potential for co-occurring mental health disorders complicating the diagnosis.
  • Variability in clinical presentation among patients.

Audit Risk Factors

  • Inadequate documentation of the mood disorder's severity.
  • Failure to document the relationship between opioid use and mood symptoms.
  • Lack of evidence for ongoing treatment and monitoring.
  • Misclassification of opioid use as dependence rather than abuse.

Specialty Focus

Medical Specialties

Psychiatry

Documentation Requirements

Detailed mental health assessments, including mood evaluations and substance use history.

Common Clinical Scenarios

Patients presenting with mood disturbances linked to opioid use, requiring psychiatric intervention.

Billing Considerations

Consideration of dual diagnosis and the impact of opioid withdrawal on mood.

Addiction Medicine

Documentation Requirements

Comprehensive substance use assessments and treatment plans.

Common Clinical Scenarios

Patients in recovery programs experiencing mood disorders related to opioid use.

Billing Considerations

Integration of behavioral health and substance use treatment strategies.

Coding Guidelines

Inclusion Criteria

Use F11.14 When
  • According to ICD
  • 10 guidelines, F11
  • 14 should be used when there is clear documentation of opioid abuse and a mood disorder directly resulting from opioid use
  • It is important to differentiate this from other mood disorders that may not be related to substance use

Exclusion Criteria

Do NOT use F11.14 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

H0031CPT Code

Mental health assessment

Clinical Scenario

Used during initial evaluations for patients with opioid-induced mood disorders.

Documentation Requirements

Comprehensive assessment notes detailing mood symptoms and substance use history.

Specialty Considerations

Psychiatric evaluations must include 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 opioid-related disorders, improving the ability to track and treat these complex conditions effectively.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of opioid-related disorders, improving the ability to track and treat these complex conditions effectively.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of opioid-related disorders, improving the ability to track and treat these complex conditions effectively.

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 is the difference between opioid abuse and opioid dependence?

Opioid abuse refers to the harmful use of opioids despite negative consequences, while opioid dependence involves a physical and psychological reliance on the substance, often requiring increased doses to achieve the same effect.