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ICD-10 Guide
ICD-10 CodesF11.229

F11.229

Billable

Opioid dependence with intoxication, unspecified

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

Code Description

ICD-10 F11.229 is a billable code used to indicate a diagnosis of opioid dependence with intoxication, unspecified.

Key Diagnostic Point:

Opioid dependence with intoxication, unspecified (F11.229) refers to a clinical condition characterized by a problematic pattern of opioid use leading to significant impairment or distress, accompanied by recent opioid intoxication. This diagnosis encompasses individuals who exhibit a strong desire to consume opioids, develop tolerance, and experience withdrawal symptoms when not using. Intoxication may manifest as euphoria, sedation, respiratory depression, or altered mental status. The unspecified nature of this code indicates that the specific opioid involved is not documented, which can complicate treatment and management. Opioid dependence is a chronic condition that often requires comprehensive treatment strategies, including behavioral therapies, medication-assisted treatment (MAT) with buprenorphine or methadone, and psychosocial support. The lack of specification in the code may lead to challenges in tailoring treatment plans and understanding the full scope of the patient's substance use disorder.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Unspecified nature of the code can lead to ambiguity in treatment planning.
  • Variability in opioid types and their effects complicates clinical management.
  • Documentation must clearly indicate the presence of both dependence and intoxication.
  • Differentiating between intoxication and withdrawal symptoms can be challenging.

Audit Risk Factors

  • Inadequate documentation of intoxication symptoms.
  • Failure to specify the opioid type used.
  • Lack of evidence for the diagnosis of dependence.
  • Inconsistent coding of co-occurring mental health disorders.

Specialty Focus

Medical Specialties

Addiction Medicine

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with overdose symptoms, requiring detoxification and stabilization.

Billing Considerations

Consideration of co-occurring mental health disorders and the need for integrated treatment approaches.

Psychiatry

Documentation Requirements

Detailed mental health evaluations, including assessment of mood, behavior, and cognitive function.

Common Clinical Scenarios

Patients with opioid dependence presenting with anxiety or depressive symptoms.

Billing Considerations

Documentation must reflect the interplay between substance use and mental health conditions.

Coding Guidelines

Inclusion Criteria

Use F11.229 When
  • According to the ICD
  • CM coding guidelines, F11
  • 229 should be used when a patient meets the criteria for opioid dependence and exhibits signs of intoxication
  • Documentation must support both the diagnosis of dependence and the presence of intoxication
  • It is essential to ensure that the code reflects the current clinical status of the patient

Exclusion Criteria

Do NOT use F11.229 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

H0020CPT Code

Behavioral health counseling and therapy

Clinical Scenario

Used in conjunction with F11.229 for patients receiving therapy for opioid dependence.

Documentation Requirements

Document the type and duration of therapy provided.

Specialty Considerations

Addiction specialists should ensure comprehensive treatment plans are documented.

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, including the ability to capture the nuances of dependence and intoxication. This specificity aids in better tracking of opioid use disorders and informs treatment strategies.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of opioid-related disorders, including the ability to capture the nuances of dependence and intoxication. This specificity aids in better tracking of opioid use disorders and informs treatment strategies.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of opioid-related disorders, including the ability to capture the nuances of dependence and intoxication. This specificity aids in better tracking of opioid use disorders and informs treatment strategies.

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 dependence and opioid intoxication?

Opioid dependence refers to a chronic condition characterized by a compulsive pattern of opioid use, while opioid intoxication refers to the acute effects experienced after consuming opioids, such as euphoria or sedation.