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ICD-10 Guide
ICD-10 CodesF13.220

F13.220

Billable

Sedative, hypnotic or anxiolytic dependence with intoxication, uncomplicated

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

Code Description

ICD-10 F13.220 is a billable code used to indicate a diagnosis of sedative, hypnotic or anxiolytic dependence with intoxication, uncomplicated.

Key Diagnostic Point:

F13.220 refers to a condition characterized by a dependence on sedative, hypnotic, or anxiolytic substances, accompanied by intoxication that is uncomplicated. This diagnosis indicates that the individual has developed a tolerance to these substances, requiring increased amounts to achieve the desired effect, and experiences withdrawal symptoms when not using them. Intoxication is marked by symptoms such as drowsiness, confusion, and impaired coordination. The uncomplicated nature of this diagnosis suggests that there are no additional complications such as withdrawal seizures or other severe medical issues. Treatment typically involves a combination of medical detoxification, counseling, and support groups to help the individual manage their dependence and work towards recovery. Understanding the nuances of this diagnosis is crucial for effective treatment planning and coding accuracy.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between uncomplicated and complicated intoxication.
  • Understanding the nuances of substance dependence versus abuse.
  • Identifying the specific sedative, hypnotic, or anxiolytic involved.
  • Documenting the severity and duration of symptoms accurately.

Audit Risk Factors

  • Inadequate documentation of intoxication symptoms.
  • Failure to specify the substance involved.
  • Misclassification of dependence as abuse.
  • Lack of evidence for treatment plans in medical records.

Specialty Focus

Medical Specialties

Addiction Medicine

Documentation Requirements

Comprehensive assessment of substance use history, current symptoms, and treatment plans.

Common Clinical Scenarios

Patients presenting with withdrawal symptoms, seeking detoxification, or requiring long-term management.

Billing Considerations

Documentation must clearly differentiate between dependence and abuse, and specify the substance involved.

Psychiatry

Documentation Requirements

Detailed mental health evaluations, including co-occurring disorders.

Common Clinical Scenarios

Patients with anxiety disorders using anxiolytics, presenting with dependence symptoms.

Billing Considerations

Consideration of the patient's mental health history and potential for dual diagnoses.

Coding Guidelines

Inclusion Criteria

Use F13.220 When
  • According to ICD
  • 10 coding guidelines, F13
  • 220 should be used when the patient meets the criteria for dependence on sedative, hypnotic, or anxiolytic substances with documented intoxication
  • It is essential to ensure that the intoxication is uncomplicated and does not involve severe withdrawal symptoms or other complications

Exclusion Criteria

Do NOT use F13.220 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 dependence.

Documentation Requirements

Detailed notes on the patient's substance use history and current symptoms.

Specialty Considerations

Addiction specialists may require more comprehensive 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 dependence and intoxication. This specificity aids in better treatment planning and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of substance use disorders, including the differentiation between dependence and intoxication. This specificity aids in better treatment planning and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of substance use disorders, including the differentiation between dependence and intoxication. This specificity aids in better treatment planning and resource allocation.

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 in the context of F13.220?

Dependence refers to a physical and psychological reliance on a substance, characterized by tolerance and withdrawal symptoms, while abuse indicates a pattern of use that leads to significant impairment or distress without necessarily meeting the criteria for dependence.