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ICD-10 Guide
ICD-10 CodesF11.929

F11.929

Billable

Opioid use, unspecified with intoxication, unspecified

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

Code Description

ICD-10 F11.929 is a billable code used to indicate a diagnosis of opioid use, unspecified with intoxication, unspecified.

Key Diagnostic Point:

F11.929 refers to a diagnosis of opioid use disorder characterized by the use of opioids, which may include prescription pain relievers, heroin, or synthetic opioids. This code is used when the specific type of opioid is not documented, and the patient is experiencing intoxication, which can manifest as altered mental status, respiratory depression, or other physiological effects. Opioid use disorder is a chronic condition that can lead to significant health complications, including overdose and death. Treatment typically involves a combination of behavioral therapies and medications, such as methadone or buprenorphine, to manage withdrawal symptoms and cravings. The unspecified nature of this code indicates that further specificity regarding the type of opioid or the severity of intoxication is not provided, which can complicate treatment planning and insurance reimbursement. Accurate documentation is crucial for effective management and coding of this condition, as it impacts the patient's treatment pathway and potential for recovery.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Lack of specificity regarding the type of opioid used
  • Variability in clinical presentation of intoxication
  • Need for comprehensive documentation to support the diagnosis
  • Potential overlap with other substance use disorders

Audit Risk Factors

  • Insufficient documentation of opioid type and dosage
  • Inconsistent clinical notes regarding intoxication symptoms
  • Lack of evidence for treatment interventions provided
  • Failure to document patient history of substance use

Specialty Focus

Medical Specialties

Addiction Medicine

Documentation Requirements

Detailed history of substance use, treatment history, and current medications.

Common Clinical Scenarios

Patients presenting with overdose symptoms, withdrawal management, or seeking treatment for opioid use disorder.

Billing Considerations

Consideration of co-occurring mental health disorders and comprehensive treatment plans.

Emergency Medicine

Documentation Requirements

Immediate assessment of intoxication symptoms, vital signs, and interventions performed.

Common Clinical Scenarios

Patients arriving in the emergency department with suspected opioid overdose.

Billing Considerations

Rapid assessment and intervention are critical; documentation must reflect urgency and interventions.

Coding Guidelines

Inclusion Criteria

Use F11.929 When
  • According to ICD
  • 10 coding guidelines, F11
  • 929 should be used when the specific opioid is not documented, and the intoxication is unspecified
  • Coders should ensure that the documentation supports the diagnosis and reflects the patient's clinical status accurately

Exclusion Criteria

Do NOT use F11.929 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

H0033CPT Code

Mental health counseling

Clinical Scenario

Used for patients receiving counseling for opioid use disorder.

Documentation Requirements

Document the nature of counseling and patient engagement.

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 detailed coding of substance use disorders, but the use of unspecified codes like F11.929 may lead to challenges in treatment planning and reimbursement. Coders must ensure that documentation is thorough to support the use of this code.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more detailed coding of substance use disorders, but the use of unspecified codes like F11.929 may lead to challenges in treatment planning and reimbursement. Coders must ensure that documentation is thorough to support the use of this code.

Reimbursement & Billing Impact

reimbursement. Coders must ensure that documentation is thorough to support the use of this code.

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

When should I use F11.929 instead of a more specific opioid code?

Use F11.929 when the specific type of opioid is not documented, and the patient is experiencing unspecified intoxication. If the opioid type is known, a more specific code should be used.