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ICD-10 Guide
ICD-10 CodesF13.97

F13.97

Billable

Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced persisting dementia

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

Code Description

ICD-10 F13.97 is a billable code used to indicate a diagnosis of sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced persisting dementia.

Key Diagnostic Point:

F13.97 refers to a condition characterized by the use of sedative, hypnotic, or anxiolytic substances that leads to persisting dementia. This diagnosis is relevant for individuals who have developed cognitive impairment due to prolonged use of these substances, which can include benzodiazepines, barbiturates, and other sedative medications. The dementia induced by these substances is not only a result of their pharmacological effects but also reflects the neurotoxic potential of long-term use. Patients may exhibit memory deficits, impaired judgment, and difficulties in daily functioning. This code is crucial for identifying patients who require specialized treatment plans that address both their substance use disorder and cognitive deficits. Treatment may involve a multidisciplinary approach, including detoxification, cognitive rehabilitation, and psychotherapy, to manage both the addiction and the cognitive impairments effectively.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Differentiating between substance-induced dementia and other types of dementia.
  • Understanding the nuances of substance use disorders and their impact on cognitive function.
  • Documenting the duration and severity of substance use.
  • Identifying co-occurring mental health disorders.

Audit Risk Factors

  • Inadequate documentation of the patient's cognitive status.
  • Failure to specify the type of sedative or hypnotic used.
  • Lack of evidence for the duration of substance use.
  • Not documenting co-occurring mental health conditions.

Specialty Focus

Medical Specialties

Psychiatry

Documentation Requirements

Comprehensive mental health assessments, including cognitive evaluations and substance use history.

Common Clinical Scenarios

Patients presenting with cognitive decline and a history of sedative use.

Billing Considerations

Careful monitoring of cognitive function and substance withdrawal symptoms.

Addiction Medicine

Documentation Requirements

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

Common Clinical Scenarios

Patients undergoing detoxification with cognitive impairments.

Billing Considerations

Integration of cognitive rehabilitation strategies into treatment.

Coding Guidelines

Inclusion Criteria

Use F13.97 When
  • Follow the ICD
  • CM coding guidelines for substance use disorders, ensuring accurate documentation of the patient's history, symptoms, and treatment plans
  • Include specific details about the type of sedative or anxiolytic used and the duration of use

Exclusion Criteria

Do NOT use F13.97 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

H0031CPT Code

Mental health assessment

Clinical Scenario

Used when assessing cognitive function in patients with substance use disorders.

Documentation Requirements

Detailed assessment notes and cognitive testing results.

Specialty Considerations

Psychiatrists should document the impact of substance use on cognitive function.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more precise coding of substance use disorders and their complications, such as persisting dementia. This specificity aids in better tracking of treatment outcomes and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more precise coding of substance use disorders and their complications, such as persisting dementia. This specificity aids in better tracking of treatment outcomes and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more precise coding of substance use disorders and their complications, such as persisting dementia. This specificity aids in better tracking of treatment outcomes 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 significance of F13.97 in clinical practice?

F13.97 is significant as it highlights the intersection of substance use disorders and cognitive impairment, necessitating a comprehensive treatment approach that addresses both issues.