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ICD-10 Guide
ICD-10 CodesF55.1

F55.1

Billable

Abuse of herbal or folk remedies

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

Code Description

ICD-10 F55.1 is a billable code used to indicate a diagnosis of abuse of herbal or folk remedies.

Key Diagnostic Point:

F55.1 refers to the abuse of herbal or folk remedies, which can manifest in various ways, including the misuse of these substances for self-medication or as a substitute for conventional medical treatment. Patients may turn to herbal remedies in an attempt to manage conditions such as eating disorders, sleep disorders, sexual dysfunction, or behavioral syndromes. The abuse of these remedies can lead to adverse health effects, including toxicity, drug interactions, and exacerbation of underlying conditions. For instance, individuals with eating disorders may misuse herbal supplements in an attempt to control weight, while those with sleep disorders might rely on herbal sedatives that can disrupt normal sleep patterns. Sexual dysfunction may also be addressed through unregulated herbal products, which can lead to psychological dependence. Behavioral syndromes, such as anxiety or depression, may be treated with folk remedies that lack scientific validation, potentially delaying appropriate medical intervention. Clinicians must be aware of the potential for abuse and the need for comprehensive assessments to ensure safe and effective treatment plans.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of herbal and folk remedies leading to inconsistent documentation
  • Potential for overlapping symptoms with other mental health disorders
  • Need for thorough patient history to establish misuse
  • Variability in patient understanding of herbal remedy effects

Audit Risk Factors

  • Inconsistent documentation of herbal remedy use
  • Failure to document patient education regarding risks
  • Lack of follow-up on adverse effects
  • Misclassification of symptoms as solely related to herbal use

Specialty Focus

Medical Specialties

Psychiatry

Documentation Requirements

Detailed patient history including substance use, mental health assessments, and treatment plans.

Common Clinical Scenarios

Patients presenting with anxiety or depression who self-medicate with herbal remedies.

Billing Considerations

Consideration of potential interactions with prescribed psychiatric medications.

Nutrition

Documentation Requirements

Comprehensive dietary assessments and documentation of herbal supplement use.

Common Clinical Scenarios

Patients with eating disorders using herbal products for weight control.

Billing Considerations

Monitoring for nutritional deficiencies and educating patients on safe supplement use.

Coding Guidelines

Inclusion Criteria

Use F55.1 When
  • According to ICD
  • 10 guidelines, F55
  • 1 should be used when there is clear evidence of abuse of herbal or folk remedies
  • It is important to document the specific remedies used, the context of their use, and any associated health issues

Exclusion Criteria

Do NOT use F55.1 When
  • Exclusion criteria include cases where herbal remedies are used appropriately under medical supervision

Related ICD-10 Codes

Related CPT Codes

99213CPT Code

Established patient office visit, Level 3

Clinical Scenario

Used when evaluating a patient for herbal remedy abuse.

Documentation Requirements

Document the patient's history, current medications, and any herbal remedies used.

Specialty Considerations

Psychiatric evaluations may require additional documentation of mental health history.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like F55.1, enabling better tracking of herbal remedy abuse and its implications on health. This specificity aids in research and treatment planning.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like F55.1, enabling better tracking of herbal remedy abuse and its implications on health. This specificity aids in research and treatment planning.

Reimbursement & Billing Impact

impact on their health, and any treatment plans. Clear notes on patient education regarding the risks of herbal use are essential.

Resources

Clinical References

  • •
    National Center for Complementary and Integrative Health

Coding & Billing References

  • •
    National Center for Complementary and Integrative Health

Frequently Asked Questions

What constitutes abuse of herbal remedies?

Abuse of herbal remedies occurs when individuals use these products inappropriately, often in excessive amounts or without medical supervision, leading to adverse health effects.