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ICD-10 Guide
ICD-10 CodesF11.288

F11.288

Billable

Opioid dependence with other opioid-induced disorder

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

Code Description

ICD-10 F11.288 is a billable code used to indicate a diagnosis of opioid dependence with other opioid-induced disorder.

Key Diagnostic Point:

Opioid dependence with other opioid-induced disorder refers to a condition where an individual exhibits a pattern of opioid use that leads to significant impairment or distress, characterized by a strong desire to consume opioids, difficulties in controlling use, and continued use despite harmful consequences. This code specifically captures cases where the individual experiences additional opioid-induced disorders, which may include opioid-induced mood disorders, anxiety disorders, or other mental health issues. The complexity of opioid dependence arises from the multifaceted nature of addiction, which can involve physical dependence, psychological dependence, and withdrawal symptoms. Treatment often requires a comprehensive approach, including medication-assisted treatment (MAT) with buprenorphine or methadone, counseling, and support groups. Clinicians must carefully document the presence of both opioid dependence and any co-occurring opioid-induced disorders to ensure accurate coding and appropriate treatment planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between opioid dependence and other substance use disorders
  • Identifying co-occurring opioid-induced disorders
  • Documenting withdrawal symptoms and their severity
  • Understanding the nuances of treatment plans involving MAT

Audit Risk Factors

  • Inadequate documentation of opioid-induced disorders
  • Failure to document the severity of dependence
  • Lack of evidence for treatment plans involving MAT
  • Inconsistent coding of withdrawal symptoms

Specialty Focus

Medical Specialties

Addiction Medicine

Documentation Requirements

Detailed history of substance use, treatment history, and any co-occurring mental health disorders.

Common Clinical Scenarios

Patients presenting with opioid use disorder and comorbid psychiatric conditions.

Billing Considerations

Ensure comprehensive documentation of both opioid dependence and any additional disorders for accurate coding.

Psychiatry

Documentation Requirements

Thorough psychiatric evaluation, including assessment of mood and anxiety symptoms related to opioid use.

Common Clinical Scenarios

Patients experiencing mood disorders secondary to opioid dependence.

Billing Considerations

Document the relationship between opioid use and psychiatric symptoms to support coding.

Coding Guidelines

Inclusion Criteria

Use F11.288 When
  • According to the ICD
  • CM coding guidelines, F11
  • 288 should be used when a patient has a documented opioid dependence along with other opioid
  • induced disorders
  • Coders must ensure that the documentation supports the diagnosis and reflects the complexity of the patient's condition

Exclusion Criteria

Do NOT use F11.288 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

H0020CPT Code

Alcohol and/or drug assessment

Clinical Scenario

Used when assessing a patient for substance use disorders.

Documentation Requirements

Document the assessment findings and treatment recommendations.

Specialty Considerations

Addiction specialists should ensure comprehensive evaluations are performed.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of opioid dependence and related disorders, improving the ability to track and manage these conditions in clinical practice.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of opioid dependence and related disorders, improving the ability to track and manage these conditions in clinical practice.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of opioid dependence and related disorders, improving the ability to track and manage these conditions in clinical practice.

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 use disorder?

Opioid dependence is a specific diagnosis that indicates a physical reliance on opioids, while opioid use disorder encompasses a broader range of behaviors and symptoms related to opioid use, including psychological dependence.