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ICD-10 Guide
ICD-10 CodesF11.222

F11.222

Billable

Opioid dependence with intoxication with perceptual disturbance

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

Code Description

ICD-10 F11.222 is a billable code used to indicate a diagnosis of opioid dependence with intoxication with perceptual disturbance.

Key Diagnostic Point:

F11.222 refers to a condition characterized by a pattern of opioid use leading to clinically significant impairment or distress, specifically with the presence of intoxication that includes perceptual disturbances. Opioid dependence is marked by a strong desire to consume opioids, tolerance to their effects, and withdrawal symptoms upon cessation. Intoxication can lead to altered sensory perceptions, such as hallucinations or distortions in reality, which can complicate the clinical picture. This condition often requires a comprehensive treatment approach, including detoxification, behavioral therapies, and possibly medication-assisted treatment (MAT) with agents like buprenorphine or methadone. The presence of perceptual disturbances necessitates careful monitoring and management to ensure patient safety and effective treatment outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between intoxication and withdrawal symptoms
  • Identifying the presence of perceptual disturbances
  • Documenting the severity of opioid dependence
  • Understanding the nuances of substance use disorder classifications

Audit Risk Factors

  • Inadequate documentation of perceptual disturbances
  • Failure to specify the type of opioid involved
  • Misclassification of intoxication versus withdrawal
  • Lack of comprehensive treatment plans in the medical record

Specialty Focus

Medical Specialties

Addiction Medicine

Documentation Requirements

Detailed history of substance use, assessment of dependence severity, and treatment plan.

Common Clinical Scenarios

Patients presenting with acute intoxication, withdrawal symptoms, or seeking treatment for opioid use disorder.

Billing Considerations

Ensure that all aspects of the patient's substance use history are documented, including previous treatments and responses.

Psychiatry

Documentation Requirements

Comprehensive mental health evaluation, including assessment of co-occurring disorders.

Common Clinical Scenarios

Patients with opioid dependence experiencing psychotic symptoms or mood disorders.

Billing Considerations

Document any psychiatric evaluations and treatment plans that address both substance use and mental health.

Coding Guidelines

Inclusion Criteria

Use F11.222 When
  • According to ICD
  • 10 guidelines, F11
  • 222 should be used when the patient meets criteria for opioid dependence and exhibits intoxication with perceptual disturbances
  • Documentation must clearly reflect the clinical presentation and treatment plan

Exclusion Criteria

Do NOT use F11.222 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

H0033CPT Code

Medication-assisted treatment

Clinical Scenario

Used in conjunction with F11.222 for patients receiving buprenorphine.

Documentation Requirements

Document the treatment plan, medication dosage, and patient response.

Specialty Considerations

Addiction specialists should ensure compliance with MAT 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, improving the ability to capture the complexity of conditions like F11.222. 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 opioid-related disorders, improving the ability to capture the complexity of conditions like F11.222. 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 opioid-related disorders, improving the ability to capture the complexity of conditions like F11.222. 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 F11.222 and F11.221?

F11.222 includes the presence of perceptual disturbances during opioid intoxication, while F11.221 does not. Accurate documentation of symptoms is crucial for correct coding.