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ICD-10 Guide
ICD-10 CodesF13.121

F13.121

Billable

Sedative, hypnotic or anxiolytic abuse with intoxication delirium

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

Code Description

ICD-10 F13.121 is a billable code used to indicate a diagnosis of sedative, hypnotic or anxiolytic abuse with intoxication delirium.

Key Diagnostic Point:

F13.121 refers to a condition characterized by the abuse of sedative, hypnotic, or anxiolytic substances, leading to a state of intoxication delirium. This condition is marked by a significant impairment in cognitive function, including confusion, disorientation, and altered consciousness, which can result from the excessive use of medications such as benzodiazepines or barbiturates. Patients may exhibit symptoms such as drowsiness, slurred speech, and impaired coordination. The diagnosis requires a thorough assessment of the patient's substance use history, including the frequency and quantity of substance intake, as well as the presence of withdrawal symptoms when not using the substance. Treatment typically involves a combination of medical detoxification, psychological support, and rehabilitation programs aimed at addressing the underlying substance use disorder. Clinicians must carefully monitor patients for potential complications, including respiratory depression and the risk of overdose, which can be life-threatening.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between intoxication and withdrawal symptoms
  • Understanding the nuances of substance abuse versus dependence
  • Documenting the severity of delirium and its impact on functioning
  • Navigating the overlap with other mental health disorders

Audit Risk Factors

  • Inadequate documentation of substance use history
  • Failure to specify the type of sedative or anxiolytic used
  • Lack of evidence for the severity of delirium
  • Misclassification of intoxication versus withdrawal

Specialty Focus

Medical Specialties

Psychiatry

Documentation Requirements

Detailed psychiatric evaluation, including mental status examination and substance use history.

Common Clinical Scenarios

Patients presenting with acute confusion, altered mental status, or overdose symptoms.

Billing Considerations

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

Addiction Medicine

Documentation Requirements

Comprehensive assessment of substance use patterns, including frequency, quantity, and impact on daily functioning.

Common Clinical Scenarios

Patients in withdrawal or seeking detoxification services.

Billing Considerations

Coordination with mental health services for dual diagnosis treatment.

Coding Guidelines

Inclusion Criteria

Use F13.121 When
  • According to ICD
  • 10 coding guidelines, F13
  • 121 should be used when there is clear evidence of sedative, hypnotic, or anxiolytic abuse accompanied by delirium
  • Documentation must support the diagnosis, including the patient's substance use history and current symptoms

Exclusion Criteria

Do NOT use F13.121 When
  • Exclusion criteria include cases where delirium is caused by other medical conditions

Related ICD-10 Codes

Related CPT Codes

H0031CPT Code

Mental health assessment

Clinical Scenario

Used during initial evaluation of a patient with suspected substance use disorder.

Documentation Requirements

Comprehensive assessment notes including history and mental status.

Specialty Considerations

Psychiatric evaluation must be thorough to support diagnosis.

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, including the differentiation between types of substance abuse and associated complications like delirium. This specificity aids in better tracking of treatment outcomes and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of substance use disorders, including the differentiation between types of substance abuse and associated complications like delirium. This specificity aids in better tracking of treatment outcomes and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of substance use disorders, including the differentiation between types of substance abuse and associated complications like delirium. This specificity aids in better tracking of treatment outcomes and resource allocation.

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 F13.120 and F13.121?

F13.120 refers to sedative, hypnotic, or anxiolytic abuse without the presence of intoxication delirium, while F13.121 specifically includes cases where the patient exhibits delirium as a result of substance abuse.