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ICD-10 Guide
ICD-10 CodesF11.981

F11.981

Billable

Opioid use, unspecified with opioid-induced sexual dysfunction

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

Code Description

ICD-10 F11.981 is a billable code used to indicate a diagnosis of opioid use, unspecified with opioid-induced sexual dysfunction.

Key Diagnostic Point:

F11.981 refers to a condition characterized by the use of opioids, which are substances that can lead to addiction and various health complications. Opioid use disorder is a complex condition that involves a compulsive pattern of opioid consumption, leading to significant impairment or distress. This code specifically highlights the presence of opioid-induced sexual dysfunction, a common side effect of opioid use. Patients may experience decreased libido, erectile dysfunction, or other sexual health issues as a direct result of opioid consumption. The interplay between opioid use and sexual dysfunction can complicate treatment, as healthcare providers must address both the substance use disorder and the associated sexual health concerns. Effective management often requires a multidisciplinary approach, including behavioral therapies, medication-assisted treatment (MAT), and counseling to address the psychological and physiological aspects of addiction and its effects on sexual health.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of opioid substances leading to different clinical presentations
  • Need for comprehensive documentation of both substance use and sexual dysfunction
  • Potential overlap with other substance use disorders
  • Variability in patient responses to opioids and treatment regimens

Audit Risk Factors

  • Inadequate documentation of opioid use history
  • Failure to document the specific nature of sexual dysfunction
  • Misclassification of opioid use severity
  • Lack of evidence for treatment plans addressing both conditions

Specialty Focus

Medical Specialties

Addiction Medicine

Documentation Requirements

Detailed history of opioid use, treatment plans, and assessments of sexual health.

Common Clinical Scenarios

Patients presenting with opioid use disorder and complaints of sexual dysfunction.

Billing Considerations

Consideration of the impact of opioid withdrawal on sexual health.

Urology

Documentation Requirements

Assessment of sexual function, including specific tests and patient-reported outcomes.

Common Clinical Scenarios

Men with erectile dysfunction who have a history of opioid use.

Billing Considerations

Need for collaboration with addiction specialists for comprehensive care.

Coding Guidelines

Inclusion Criteria

Use F11.981 When
  • According to ICD
  • 10 guidelines, F11
  • 981 should be used when there is clear documentation of opioid use disorder alongside sexual dysfunction
  • It is essential to differentiate between primary sexual dysfunction due to opioids and other potential causes

Exclusion Criteria

Do NOT use F11.981 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99406CPT Code

Smoking and tobacco use cessation counseling visit

Clinical Scenario

When a patient with opioid use disorder also seeks help for smoking cessation.

Documentation Requirements

Document the patient's smoking history and cessation attempts.

Specialty Considerations

Consider the impact of tobacco use on overall health and recovery.

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 and their complications, improving the ability to track and manage these conditions effectively.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of opioid use disorders and their complications, improving the ability to track and manage these conditions effectively.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of opioid use disorders and their complications, improving the ability to track and manage these conditions effectively.

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 F11.981?

Coding F11.981 is crucial for accurately capturing the complexities of opioid use disorder and its impact on sexual health, which can inform treatment strategies and improve patient outcomes.