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ICD-10 Guide
ICD-10 CodesF11.24

F11.24

Billable

Opioid dependence with opioid-induced mood disorder

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

Code Description

ICD-10 F11.24 is a billable code used to indicate a diagnosis of opioid dependence with opioid-induced mood disorder.

Key Diagnostic Point:

Opioid dependence with opioid-induced mood disorder is characterized by a problematic pattern of opioid use leading to clinically significant impairment or distress. This condition arises when an individual develops a tolerance to opioids, experiences withdrawal symptoms, and continues to use opioids despite adverse consequences. The mood disorder component indicates that the opioid use has led to significant mood disturbances, such as depression or anxiety, which are directly attributable to the substance use. Clinically, patients may present with symptoms like persistent sadness, irritability, or anhedonia, which can complicate the treatment of their opioid dependence. Effective management often requires a multidisciplinary approach, including pharmacotherapy (such as methadone or buprenorphine), psychotherapy, and support groups. The interplay between opioid dependence and mood disorders necessitates careful monitoring and tailored treatment strategies to address both the substance use and the mood disorder effectively.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between opioid dependence and other substance use disorders.
  • Identifying the presence of mood disorders and their severity.
  • Understanding the nuances of withdrawal and intoxication symptoms.
  • Navigating treatment options that address both opioid dependence and mood disorders.

Audit Risk Factors

  • Inadequate documentation of mood disorder symptoms.
  • Failure to document the treatment plan for both opioid dependence and mood disorder.
  • Lack of evidence for the diagnosis of opioid dependence.
  • Misclassification of opioid withdrawal or intoxication symptoms.

Specialty Focus

Medical Specialties

Addiction Medicine

Documentation Requirements

Comprehensive assessment of substance use history, mood symptoms, and treatment response.

Common Clinical Scenarios

Patients presenting with opioid use disorder and co-occurring depression or anxiety.

Billing Considerations

Documentation must clearly outline the relationship between opioid use and mood symptoms.

Psychiatry

Documentation Requirements

Detailed psychiatric evaluation including mood disorder assessment and substance use history.

Common Clinical Scenarios

Patients with a history of opioid use presenting with depressive symptoms.

Billing Considerations

Consideration of medication interactions and the impact of opioid use on mood stabilization.

Coding Guidelines

Inclusion Criteria

Use F11.24 When
  • According to ICD
  • 10 guidelines, F11
  • 24 should be used when there is clear documentation of opioid dependence accompanied by a mood disorder
  • It is essential to differentiate this from other substance use disorders and ensure that the mood disorder is directly linked to opioid use

Exclusion Criteria

Do NOT use F11.24 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

H0020CPT Code

Behavioral health counseling

Clinical Scenario

Used in conjunction with F11.24 for comprehensive treatment.

Documentation Requirements

Document the nature of counseling and its relation to opioid dependence and mood disorder.

Specialty Considerations

Addiction specialists should ensure that counseling sessions are tailored to address both substance use and mood symptoms.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of opioid dependence and associated mood disorders, improving the accuracy of diagnoses and treatment plans. 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 specific coding of opioid dependence and associated mood disorders, improving the accuracy of diagnoses and treatment plans. This specificity aids in better tracking of treatment outcomes and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of opioid dependence and associated mood disorders, improving the accuracy of diagnoses and treatment plans. 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 coding F11.24?

Coding F11.24 is crucial for accurately representing the complexity of a patient's condition, which includes both opioid dependence and mood disorder. This specificity helps in tailoring treatment plans and ensuring appropriate reimbursement for services rendered.