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ICD-10 Guide
ICD-10 CodesF11.922

F11.922

Billable

Opioid use, unspecified with intoxication with perceptual disturbance

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

Code Description

ICD-10 F11.922 is a billable code used to indicate a diagnosis of opioid use, unspecified with intoxication with perceptual disturbance.

Key Diagnostic Point:

F11.922 refers to a condition characterized by the use of opioids, which are substances that act on the nervous system to relieve pain but can lead to addiction and other health issues. This specific code indicates that the individual is experiencing intoxication from opioid use, accompanied by perceptual disturbances, which may include hallucinations or altered sensory perceptions. The diagnosis is crucial as it highlights the severity of the opioid use disorder and the immediate risks associated with intoxication. Opioid use disorder is a complex condition that often requires comprehensive treatment approaches, including medication-assisted treatment (MAT), counseling, and support groups. The presence of perceptual disturbances can complicate the clinical picture, necessitating careful monitoring and management to ensure patient safety and effective treatment outcomes. Clinicians must document the specifics of the intoxication episode, including the type of opioid used, the duration of use, and any co-occurring mental health conditions, to provide a clear clinical picture for accurate coding and treatment planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in opioid types and their effects
  • Need for detailed documentation of perceptual disturbances
  • Differentiation from other substance use disorders
  • Potential for co-occurring mental health issues

Audit Risk Factors

  • Inadequate documentation of intoxication symptoms
  • Failure to specify the type of opioid used
  • Lack of evidence for perceptual disturbances
  • Inconsistent coding with treatment records

Specialty Focus

Medical Specialties

Addiction Medicine

Documentation Requirements

Detailed history of substance use, specific symptoms of intoxication, and treatment plans.

Common Clinical Scenarios

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

Billing Considerations

Consideration of co-occurring mental health disorders and the need for a multidisciplinary approach.

Psychiatry

Documentation Requirements

Comprehensive mental health evaluation, including assessment of perceptual disturbances and their impact on functioning.

Common Clinical Scenarios

Patients with a history of substance use presenting with psychotic symptoms or mood disturbances.

Billing Considerations

Need for careful assessment of the interplay between substance use and underlying psychiatric conditions.

Coding Guidelines

Inclusion Criteria

Use F11.922 When
  • According to ICD
  • 10 coding guidelines, F11
  • 922 should be used when the patient has a documented history of opioid use and presents with intoxication symptoms, specifically perceptual disturbances
  • Coders must ensure that all relevant clinical information is documented to support the diagnosis

Exclusion Criteria

Do NOT use F11.922 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

H0020CPT Code

Behavioral health counseling

Clinical Scenario

Used for patients receiving counseling for opioid use disorder.

Documentation Requirements

Document the nature of counseling and the patient's progress.

Specialty Considerations

Addiction specialists should ensure comprehensive treatment plans are in place.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of opioid use disorders, enabling better tracking of treatment outcomes and resource allocation. F11.922 provides a clear framework for identifying patients with complex needs related to opioid intoxication.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of opioid use disorders, enabling better tracking of treatment outcomes and resource allocation. F11.922 provides a clear framework for identifying patients with complex needs related to opioid intoxication.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of opioid use disorders, enabling better tracking of treatment outcomes and resource allocation. F11.922 provides a clear framework for identifying patients with complex needs related to opioid intoxication.

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 documenting perceptual disturbances?

Documenting perceptual disturbances is crucial as it indicates the severity of the intoxication and may influence treatment decisions and patient safety.