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ICD-10 Guide
ICD-10 CodesF13.13

F13.13

Billable

Sedative, hypnotic or anxiolytic abuse with withdrawal

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

Code Description

ICD-10 F13.13 is a billable code used to indicate a diagnosis of sedative, hypnotic or anxiolytic abuse with withdrawal.

Key Diagnostic Point:

F13.13 refers to the abuse of sedative, hypnotic, or anxiolytic substances, which are commonly used to treat anxiety, insomnia, and other related disorders. This code specifically indicates that the individual is experiencing withdrawal symptoms as a result of the cessation or reduction of these substances after a period of abuse. Withdrawal symptoms can include anxiety, tremors, insomnia, and in severe cases, seizures. The diagnosis requires a thorough assessment of the patient's substance use history, including the type and duration of substance use, as well as the presence and severity of withdrawal symptoms. Treatment often involves a combination of medical detoxification, psychological support, and rehabilitation programs tailored to the individual's needs. It is crucial for healthcare providers to document the patient's substance use history and withdrawal symptoms accurately to ensure appropriate treatment and coding.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between abuse and dependence
  • Identifying withdrawal symptoms accurately
  • Documenting the duration and frequency of substance use
  • Understanding the nuances of sedative, hypnotic, and anxiolytic classifications

Audit Risk Factors

  • Inadequate documentation of withdrawal symptoms
  • Failure to specify the type of sedative or anxiolytic used
  • Lack of evidence for substance abuse history
  • Misclassification of substance use disorder severity

Specialty Focus

Medical Specialties

Psychiatry

Documentation Requirements

Detailed patient history, including substance use patterns and withdrawal symptoms.

Common Clinical Scenarios

Patients presenting with anxiety disorders who have a history of sedative use.

Billing Considerations

Consideration of co-occurring mental health disorders and their impact on treatment.

Addiction Medicine

Documentation Requirements

Comprehensive assessment of substance use, including frequency, duration, and withdrawal symptoms.

Common Clinical Scenarios

Patients undergoing detoxification from sedatives or anxiolytics.

Billing Considerations

Integration of behavioral therapy and pharmacotherapy in treatment plans.

Coding Guidelines

Inclusion Criteria

Use F13.13 When
  • According to ICD
  • 10 guidelines, F13
  • 13 should be used when there is clear evidence of sedative, hypnotic, or anxiolytic abuse accompanied by withdrawal symptoms
  • Documentation must support the diagnosis, including the patient's substance use history and the presence of withdrawal symptoms

Exclusion Criteria

Do NOT use F13.13 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

H0031CPT Code

Mental health assessment

Clinical Scenario

Used during initial evaluation of patients with suspected sedative withdrawal.

Documentation Requirements

Comprehensive assessment notes detailing substance use history and withdrawal symptoms.

Specialty Considerations

Psychiatric evaluations should include mental status exams and risk assessments.

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 abuse and dependence, which enhances the accuracy of treatment and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of substance use disorders, including the differentiation between abuse and dependence, which enhances the accuracy of treatment and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

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 are the primary symptoms of withdrawal from sedatives?

Withdrawal symptoms can include anxiety, tremors, insomnia, sweating, and in severe cases, seizures. The severity and duration of symptoms can vary based on the substance used and the duration of abuse.