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ICD-10 Guide
ICD-10 CodesF13.10

F13.10

Billable

Sedative, hypnotic or anxiolytic abuse, uncomplicated

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

Code Description

ICD-10 F13.10 is a billable code used to indicate a diagnosis of sedative, hypnotic or anxiolytic abuse, uncomplicated.

Key Diagnostic Point:

F13.10 refers to the abuse of sedative, hypnotic, or anxiolytic substances without the presence of complications. This condition is characterized by a pattern of use that leads to significant impairment or distress, including a strong desire to consume these substances, unsuccessful attempts to cut down or control use, and continued use despite adverse consequences. Patients may experience tolerance, where increasing amounts are needed to achieve the desired effect, and withdrawal symptoms upon cessation. Common substances in this category include benzodiazepines and barbiturates. The diagnosis is made based on clinical assessment, including patient history and behavioral observations. Treatment typically involves behavioral therapies, counseling, and support groups, with a focus on addressing underlying psychological issues and promoting recovery. It is crucial for healthcare providers to monitor patients for signs of withdrawal or overdose, as these can lead to serious health complications.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in substance types and their effects
  • Need for comprehensive patient history
  • Differentiation from other substance use disorders
  • Potential for co-occurring mental health conditions

Audit Risk Factors

  • Inadequate documentation of substance use history
  • Failure to document treatment plans or follow-ups
  • Misclassification of abuse versus dependence
  • Lack of evidence for severity of impairment

Specialty Focus

Medical Specialties

Psychiatry

Documentation Requirements

Detailed patient history, including substance use patterns and mental health evaluations.

Common Clinical Scenarios

Patients presenting with anxiety or insomnia who misuse sedatives.

Billing Considerations

Consideration of comorbid psychiatric disorders and the need for integrated treatment approaches.

Addiction Medicine

Documentation Requirements

Comprehensive assessment of substance use, including frequency, quantity, and impact on life.

Common Clinical Scenarios

Patients seeking help for substance abuse with a focus on sedatives.

Billing Considerations

Focus on harm reduction strategies and potential for withdrawal management.

Coding Guidelines

Inclusion Criteria

Use F13.10 When
  • According to ICD
  • 10 guidelines, F13
  • 10 should be used when there is evidence of abuse without complications
  • Documentation must support the diagnosis, including behavioral patterns and impact on functioning

Exclusion Criteria

Do NOT use F13.10 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

H0031CPT Code

Mental health assessment

Clinical Scenario

Used when assessing a patient for sedative abuse.

Documentation Requirements

Detailed notes on patient history and assessment findings.

Specialty Considerations

Psychiatry and addiction medicine should document the assessment thoroughly.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of substance use disorders, improving the ability to track and treat sedative, hypnotic, or anxiolytic abuse more effectively.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of substance use disorders, improving the ability to track and treat sedative, hypnotic, or anxiolytic abuse more effectively.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of substance use disorders, improving the ability to track and treat sedative, hypnotic, or anxiolytic abuse more 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 F13.10 and F13.20?

F13.10 refers to uncomplicated abuse of sedatives, while F13.20 indicates dependence, which includes withdrawal symptoms and a more severe pattern of use.