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ICD-10 Guide
ICD-10 CodesF13.19

F13.19

Billable

Sedative, hypnotic or anxiolytic abuse with unspecified sedative, hypnotic or anxiolytic-induced disorder

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

Code Description

ICD-10 F13.19 is a billable code used to indicate a diagnosis of sedative, hypnotic or anxiolytic abuse with unspecified sedative, hypnotic or anxiolytic-induced disorder.

Key Diagnostic Point:

F13.19 refers to the abuse of sedatives, hypnotics, or anxiolytics, which are substances that depress the central nervous system and are often used to treat anxiety, insomnia, and other conditions. This code is applied when a patient exhibits a pattern of use that leads to significant impairment or distress, but the specific sedative, hypnotic, or anxiolytic involved is not specified. Patients may experience a range of symptoms including withdrawal, tolerance, and cravings. The disorder can manifest as intoxication, leading to cognitive impairment, motor dysfunction, or even overdose. Treatment typically involves a combination of behavioral therapies, counseling, and, in some cases, medication to manage withdrawal symptoms. It is crucial for healthcare providers to document the patient's history of substance use, any co-occurring mental health disorders, and the impact of substance use on their daily functioning to ensure accurate coding and appropriate treatment planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in patient presentation and symptoms
  • Need for detailed documentation of substance use 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 specify the substance involved
  • Lack of evidence for the diagnosis of induced disorder
  • Inconsistent coding across different encounters

Specialty Focus

Medical Specialties

Psychiatry

Documentation Requirements

Comprehensive assessment of mental health history, substance use patterns, and treatment response.

Common Clinical Scenarios

Patients presenting with anxiety disorders, insomnia, or substance use disorders requiring psychiatric evaluation.

Billing Considerations

Consideration of co-occurring mental health disorders and the impact of substance use on treatment outcomes.

Addiction Medicine

Documentation Requirements

Detailed history of substance use, including frequency, quantity, and impact on daily life.

Common Clinical Scenarios

Patients seeking treatment for substance use disorders, including withdrawal management and relapse prevention.

Billing Considerations

Focus on comprehensive treatment plans that address both substance use and any underlying mental health issues.

Coding Guidelines

Inclusion Criteria

Use F13.19 When
  • According to ICD
  • 10 coding guidelines, F13
  • 19 should be used when there is evidence of abuse or dependence on sedatives, hypnotics, or anxiolytics, and when the specific substance is not identified
  • Documentation must support the diagnosis, including details of the patient's substance use history and any related disorders

Exclusion Criteria

Do NOT use F13.19 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

Psychiatric evaluations should include substance use history.

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 ability to capture the nuances of sedative, hypnotic, and anxiolytic abuse. This specificity aids in better tracking and treatment of these conditions.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of substance use disorders, including the ability to capture the nuances of sedative, hypnotic, and anxiolytic abuse. This specificity aids in better tracking and treatment of these conditions.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of substance use disorders, including the ability to capture the nuances of sedative, hypnotic, and anxiolytic abuse. This specificity aids in better tracking and treatment of these conditions.

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 F13.19 and F13.10?

F13.19 is used for cases of abuse without dependence, while F13.10 is for cases where dependence on sedatives, hypnotics, or anxiolytics is present.