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ICD-10 Guide
ICD-10 CodesF11.18

F11.18

Billable

Opioid abuse with other opioid-induced disorder

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

Code Description

ICD-10 F11.18 is a billable code used to indicate a diagnosis of opioid abuse with other opioid-induced disorder.

Key Diagnostic Point:

F11.18 refers to a diagnosis of opioid abuse accompanied by other opioid-induced disorders, which may include conditions such as opioid-induced mood disorders, opioid-induced psychotic disorders, or opioid-induced sleep disorders. This code is used when a patient exhibits a pattern of opioid use that leads to significant impairment or distress, and is also experiencing additional complications related to opioid use. Opioid abuse is characterized by a compulsive pattern of consumption, leading to adverse consequences in various aspects of life, including social, occupational, and interpersonal functioning. The presence of other opioid-induced disorders complicates the clinical picture, necessitating a comprehensive treatment approach that may include behavioral therapies, medication-assisted treatment (MAT), and psychosocial support. Accurate coding is essential for appropriate treatment planning and reimbursement, as well as for tracking the prevalence and impact of opioid-related disorders in the healthcare system.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between opioid abuse and dependence
  • Identifying specific opioid-induced disorders
  • Documenting the severity and impact of the disorder
  • Understanding the nuances of substance use disorder classifications

Audit Risk Factors

  • Inadequate documentation of opioid-induced disorders
  • Failure to specify the type of opioid used
  • Lack of evidence for the severity of abuse
  • Inconsistent coding of co-occurring mental health conditions

Specialty Focus

Medical Specialties

Addiction Medicine

Documentation Requirements

Detailed history of substance use, assessment of co-occurring disorders, treatment plans, and progress notes.

Common Clinical Scenarios

Patients presenting with withdrawal symptoms, overdose, or complications from opioid use.

Billing Considerations

Ensure comprehensive documentation of all opioid-related disorders and their impact on the patient's life.

Psychiatry

Documentation Requirements

Mental health evaluations, treatment history, and any psychiatric comorbidities.

Common Clinical Scenarios

Patients with mood disorders or psychosis secondary to opioid use.

Billing Considerations

Document the relationship between opioid use and psychiatric symptoms clearly.

Coding Guidelines

Inclusion Criteria

Use F11.18 When
  • According to ICD
  • 10 guidelines, F11
  • 18 should be used when opioid abuse is documented alongside other opioid
  • induced disorders
  • Coders must ensure that the documentation supports the diagnosis and that all relevant details are captured to justify the use of this code

Exclusion Criteria

Do NOT use F11.18 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

H0020CPT Code

Behavioral health counseling

Clinical Scenario

Used in conjunction with F11.18 for comprehensive treatment planning.

Documentation Requirements

Document the nature of counseling and its relation to opioid abuse.

Specialty Considerations

Ensure that the treatment plan aligns with addiction medicine guidelines.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of opioid-related disorders, enabling better tracking of opioid abuse and its complications. F11.18 provides a clear framework for documenting the complexity of cases involving both abuse and other opioid-induced disorders.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of opioid-related disorders, enabling better tracking of opioid abuse and its complications. F11.18 provides a clear framework for documenting the complexity of cases involving both abuse and other opioid-induced disorders.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of opioid-related disorders, enabling better tracking of opioid abuse and its complications. F11.18 provides a clear framework for documenting the complexity of cases involving both abuse and other opioid-induced disorders.

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 opioid abuse and opioid dependence?

Opioid abuse refers to the harmful use of opioids without meeting the criteria for dependence, while opioid dependence involves a physical and psychological reliance on opioids, often characterized by withdrawal symptoms when not using.