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ICD-10 Guide
ICD-10 CodesF13.20

F13.20

Billable

Sedative, hypnotic or anxiolytic dependence, uncomplicated

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

Code Description

ICD-10 F13.20 is a billable code used to indicate a diagnosis of sedative, hypnotic or anxiolytic dependence, uncomplicated.

Key Diagnostic Point:

F13.20 refers to a diagnosis of dependence on sedative, hypnotic, or anxiolytic substances without any accompanying complications. This condition is characterized by a compulsive pattern of use, leading to significant impairment or distress. Patients may exhibit tolerance, requiring increased dosages to achieve the desired effect, and may experience withdrawal symptoms when not using the substance. Common substances in this category include benzodiazepines and barbiturates. The diagnosis is made based on clinical evaluation, including a thorough history of substance use, assessment of withdrawal symptoms, and the impact on daily functioning. Treatment typically involves a combination of behavioral therapies and, in some cases, pharmacotherapy to manage withdrawal symptoms and support recovery. It is crucial for healthcare providers to monitor patients closely for signs of misuse and to provide education on the risks associated with long-term use of these substances.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in patient presentation and symptoms
  • Need for comprehensive documentation of substance use history
  • Potential overlap with other substance use disorders
  • Withdrawal symptoms may vary significantly among patients

Audit Risk Factors

  • Inadequate documentation of substance use history
  • Failure to document withdrawal symptoms
  • Misclassification of dependence versus abuse
  • Lack of evidence for treatment plans

Specialty Focus

Medical Specialties

Addiction Medicine

Documentation Requirements

Detailed history of substance use, treatment plans, and progress notes.

Common Clinical Scenarios

Patients presenting with withdrawal symptoms, seeking detoxification, or in need of long-term management.

Billing Considerations

Ensure accurate documentation of the severity of dependence and any co-occurring mental health disorders.

Psychiatry

Documentation Requirements

Comprehensive psychiatric evaluation, including mental status examination and risk assessment.

Common Clinical Scenarios

Patients with co-occurring anxiety disorders and sedative dependence.

Billing Considerations

Document any psychiatric comorbidities that may complicate treatment.

Coding Guidelines

Inclusion Criteria

Use F13.20 When
  • According to ICD
  • 10 guidelines, F13
  • 20 should be used when the patient meets the criteria for dependence without complications
  • Documentation must support the diagnosis, including evidence of tolerance, withdrawal, and impact on daily life

Exclusion Criteria

Do NOT use F13.20 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

H0031CPT Code

Mental health counseling

Clinical Scenario

Used in conjunction with F13.20 for therapy sessions.

Documentation Requirements

Document the number of sessions and treatment goals.

Specialty Considerations

Ensure alignment with treatment plans in addiction medicine.

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 capture the complexity of dependence and its treatment needs.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of substance use disorders, improving the ability to capture the complexity of dependence and its treatment needs.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of substance use disorders, improving the ability to capture the complexity of dependence and its treatment needs.

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 dependence and abuse?

Dependence involves a compulsive pattern of use leading to tolerance and withdrawal, while abuse refers to the harmful use of substances without necessarily meeting dependence criteria.