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ICD-10 Guide
ICD-10 CodesF13.130

F13.130

Billable

Sedative, hypnotic or anxiolytic abuse with withdrawal, uncomplicated

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

Code Description

ICD-10 F13.130 is a billable code used to indicate a diagnosis of sedative, hypnotic or anxiolytic abuse with withdrawal, uncomplicated.

Key Diagnostic Point:

F13.130 refers to the abuse of sedative, hypnotic, or anxiolytic substances, characterized by a pattern of consumption that leads to significant impairment or distress. This code specifically denotes cases where the individual is experiencing withdrawal symptoms that are uncomplicated, meaning they do not involve severe complications such as seizures or delirium. Common substances in this category include benzodiazepines and barbiturates. Withdrawal symptoms may include anxiety, insomnia, tremors, and increased heart rate. The diagnosis requires a thorough assessment of the patient's substance use history, current symptoms, and the impact on their daily functioning. Treatment often involves a gradual tapering of the substance, supportive care, and possibly the use of medications to manage withdrawal symptoms. Understanding the nuances of this diagnosis is crucial for effective treatment and accurate coding.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between uncomplicated and complicated withdrawal
  • Understanding the specific substances involved
  • Assessing the severity of withdrawal symptoms
  • Documenting the patient's history of substance use

Audit Risk Factors

  • Inadequate documentation of withdrawal symptoms
  • Failure to specify the substance involved
  • Misclassification of withdrawal severity
  • Lack of comprehensive substance use history

Specialty Focus

Medical Specialties

Addiction Medicine

Documentation Requirements

Detailed substance use history, withdrawal symptom assessment, and treatment plan.

Common Clinical Scenarios

Patients presenting with anxiety and insomnia after discontinuing benzodiazepines.

Billing Considerations

Ensure clear documentation of the timeline of substance use and withdrawal symptoms.

Psychiatry

Documentation Requirements

Comprehensive mental health evaluation, including co-occurring disorders.

Common Clinical Scenarios

Patients with anxiety disorders who misuse anxiolytics.

Billing Considerations

Document any psychiatric evaluations and treatment adjustments related to substance use.

Coding Guidelines

Inclusion Criteria

Use F13.130 When
  • According to ICD
  • 10 guidelines, F13
  • 130 should be used when the patient exhibits withdrawal symptoms without complications
  • Documentation must support the diagnosis, including the type of substance abused and the severity of withdrawal symptoms

Exclusion Criteria

Do NOT use F13.130 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 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 substance use disorders, improving the ability to track and treat these conditions effectively. F13.130 provides a clear distinction between uncomplicated withdrawal and more severe cases, aiding in appropriate treatment planning.

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 these conditions effectively. F13.130 provides a clear distinction between uncomplicated withdrawal and more severe cases, aiding in appropriate treatment planning.

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 these conditions effectively. F13.130 provides a clear distinction between uncomplicated withdrawal and more severe cases, aiding in appropriate treatment planning.

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?

Common symptoms include anxiety, insomnia, tremors, sweating, and increased heart rate. Severe cases may involve seizures or delirium.

How can I differentiate between abuse and dependence?

Abuse is characterized by a pattern of use that leads to impairment, while dependence involves a physical or psychological reliance on the substance.