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ICD-10 Guide
ICD-10 CodesF13.131

F13.131

Billable

Sedative, hypnotic or anxiolytic abuse with withdrawal delirium

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

Code Description

ICD-10 F13.131 is a billable code used to indicate a diagnosis of sedative, hypnotic or anxiolytic abuse with withdrawal delirium.

Key Diagnostic Point:

F13.131 refers to the abuse of sedative, hypnotic, or anxiolytic substances, which can lead to significant psychological and physiological dependence. This condition is characterized by a pattern of use that results in clinically significant impairment or distress, including withdrawal symptoms upon cessation. Withdrawal delirium, a severe form of withdrawal, is marked by confusion, agitation, hallucinations, and autonomic instability. Patients may experience tremors, sweating, and increased heart rate, which can escalate to life-threatening complications if not managed appropriately. Treatment typically involves a combination of pharmacological interventions to manage withdrawal symptoms and psychological support to address the underlying substance use disorder. Comprehensive treatment programs may include detoxification, counseling, and long-term rehabilitation strategies to prevent relapse and promote recovery.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Differentiating between various types of sedative, hypnotic, and anxiolytic substances.
  • Identifying the severity of withdrawal symptoms and delirium.
  • Documenting the patient's history of substance use and previous treatment attempts.
  • Understanding the interplay between mental health disorders and substance use.

Audit Risk Factors

  • Inadequate documentation of withdrawal symptoms.
  • Failure to specify the substance involved.
  • Misclassification of the severity of the condition.
  • Lack of evidence for treatment interventions provided.

Specialty Focus

Medical Specialties

Addiction Medicine

Documentation Requirements

Thorough documentation of substance use history, withdrawal symptoms, and treatment plans.

Common Clinical Scenarios

Patients presenting with acute withdrawal symptoms, requiring detoxification and stabilization.

Billing Considerations

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

Psychiatry

Documentation Requirements

Detailed mental status examinations and assessments of substance use impact on mental health.

Common Clinical Scenarios

Patients with a history of anxiety or sleep disorders exacerbated by substance use.

Billing Considerations

Monitoring for potential interactions between prescribed psychiatric medications and substances of abuse.

Coding Guidelines

Inclusion Criteria

Use F13.131 When
  • According to ICD
  • 10 coding guidelines, F13
  • 131 should be used when there is clear evidence of sedative, hypnotic, or anxiolytic abuse accompanied by withdrawal delirium
  • Documentation must support the diagnosis, including withdrawal symptoms and treatment interventions

Exclusion Criteria

Do NOT use F13.131 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

H0031CPT Code

Mental health assessment

Clinical Scenario

Used during initial evaluation of a patient presenting with withdrawal symptoms.

Documentation Requirements

Comprehensive assessment notes detailing the patient's history and current symptoms.

Specialty Considerations

Addiction specialists should focus on substance use history and mental health status.

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 manage these conditions. F13.131 provides a clear framework for identifying patients with severe withdrawal symptoms, facilitating targeted treatment approaches.

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 manage these conditions. F13.131 provides a clear framework for identifying patients with severe withdrawal symptoms, facilitating targeted treatment approaches.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of substance use disorders, improving the ability to track and manage these conditions. F13.131 provides a clear framework for identifying patients with severe withdrawal symptoms, facilitating targeted treatment approaches.

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 key symptoms of withdrawal delirium?

Key symptoms include confusion, agitation, hallucinations, tremors, and autonomic instability such as sweating and increased heart rate.