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ICD-10 Guide
ICD-10 CodesF11.29

F11.29

Billable

Opioid dependence with unspecified opioid-induced disorder

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

Code Description

ICD-10 F11.29 is a billable code used to indicate a diagnosis of opioid dependence with unspecified opioid-induced disorder.

Key Diagnostic Point:

Opioid dependence is characterized by a compulsive pattern of opioid use, leading to significant impairment or distress. This condition often manifests through a strong desire to consume opioids, tolerance to their effects, and withdrawal symptoms upon cessation. Opioid-induced disorders can include a range of symptoms such as mood disturbances, cognitive impairments, and physical health issues. The unspecified nature of the opioid-induced disorder indicates that the specific symptoms or complications have not been clearly defined or documented. Treatment typically involves a combination of pharmacotherapy, such as methadone or buprenorphine, and psychosocial interventions, including counseling and support groups. The complexity of managing opioid dependence arises from the need to address both the physical and psychological aspects of addiction, as well as the potential for co-occurring mental health disorders. Accurate coding is essential for appropriate treatment planning and reimbursement, as well as for tracking the prevalence of opioid dependence in the population.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in documentation of opioid-induced disorders
  • Need for comprehensive patient history to determine severity
  • Differentiation from other substance use disorders
  • Potential for co-occurring mental health conditions

Audit Risk Factors

  • Inadequate documentation of opioid use history
  • Failure to specify the nature of the opioid-induced disorder
  • Lack of evidence for treatment plans and follow-up
  • Inconsistent coding practices across providers

Specialty Focus

Medical Specialties

Addiction Medicine

Documentation Requirements

Detailed patient history, including substance use patterns, previous treatments, and psychosocial factors.

Common Clinical Scenarios

Patients presenting with opioid overdose, withdrawal symptoms, or seeking treatment for opioid dependence.

Billing Considerations

Documentation must clearly outline the severity of dependence and any co-occurring disorders to support the diagnosis.

Psychiatry

Documentation Requirements

Comprehensive mental health evaluations, including assessments of mood, cognition, and behavior related to opioid use.

Common Clinical Scenarios

Patients with opioid dependence experiencing anxiety, depression, or other mental health issues.

Billing Considerations

Psychiatric evaluations should include details on the impact of opioid use on mental health and any therapeutic interventions.

Coding Guidelines

Inclusion Criteria

Use F11.29 When
  • According to ICD
  • 10 guidelines, F11
  • 29 should be used when opioid dependence is confirmed, but the specific opioid
  • induced disorder is not specified
  • Coders must ensure that the diagnosis aligns with the clinical documentation and that any relevant symptoms or complications are noted

Exclusion Criteria

Do NOT use F11.29 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

H0020CPT Code

Behavioral health counseling

Clinical Scenario

Used in conjunction with F11.29 for outpatient therapy sessions.

Documentation Requirements

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

Specialty Considerations

Addiction specialists should ensure that therapy goals are clearly defined.

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 track and manage opioid dependence and its complications. F11.29 provides a framework for identifying patients with opioid dependence who may not have a clearly defined opioid-induced disorder, facilitating appropriate treatment 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 track and manage opioid dependence and its complications. F11.29 provides a framework for identifying patients with opioid dependence who may not have a clearly defined opioid-induced disorder, facilitating appropriate treatment and resource allocation.

Reimbursement & Billing Impact

reimbursement.

Resources

Clinical References

  • •
    Substance Abuse and Mental Health Services Administration (SAMHSA)
  • •
    National Institute on Drug Abuse (NIDA)

Coding & Billing References

  • •
    Substance Abuse and Mental Health Services Administration (SAMHSA)
  • •
    National Institute on Drug Abuse (NIDA)

Frequently Asked Questions

What is the difference between F11.29 and F11.20?

F11.29 is used when opioid dependence is present but the specific opioid-induced disorder is unspecified. F11.20 is used when opioid dependence is uncomplicated, without withdrawal or other complications.

Can F11.29 be used for patients in remission?

No, F11.29 should not be used for patients in remission. Instead, F11.21 should be used to indicate opioid dependence in remission.