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ICD-10 Guide
ICD-10 CodesF13.120

F13.120

Billable

Sedative, hypnotic or anxiolytic abuse with intoxication, uncomplicated

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

Code Description

ICD-10 F13.120 is a billable code used to indicate a diagnosis of sedative, hypnotic or anxiolytic abuse with intoxication, uncomplicated.

Key Diagnostic Point:

F13.120 refers to the abuse of sedative, hypnotic, or anxiolytic substances, characterized by the consumption of these drugs in a manner that is harmful or hazardous. This code specifically denotes cases where the individual is experiencing intoxication without any accompanying complications. Intoxication can manifest through various symptoms, including drowsiness, confusion, impaired coordination, and respiratory depression. The diagnosis is crucial as it helps in identifying individuals who may require immediate intervention or treatment for substance use disorders. Treatment often involves detoxification, counseling, and rehabilitation programs tailored to address the psychological and physical aspects of addiction. It is essential for healthcare providers to document the severity of the abuse, the specific substances involved, and any co-occurring mental health disorders to ensure appropriate care and coding.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between uncomplicated and complicated intoxication.
  • Identifying specific substances involved in the abuse.
  • Documenting the severity and duration of substance use.
  • Understanding the nuances of substance use disorder classifications.

Audit Risk Factors

  • Inadequate documentation of substance use history.
  • Failure to specify the type of sedative or anxiolytic used.
  • Lack of evidence for the diagnosis of intoxication.
  • Misclassification of the severity of the condition.

Specialty Focus

Medical Specialties

Addiction Medicine

Documentation Requirements

Detailed history of substance use, including types and amounts of substances abused.

Common Clinical Scenarios

Patients presenting with overdose symptoms, withdrawal symptoms, or seeking treatment for substance use disorders.

Billing Considerations

Consideration of co-occurring mental health disorders and the need for integrated treatment approaches.

Psychiatry

Documentation Requirements

Comprehensive psychiatric evaluation, including mental status examination and assessment of substance use impact on mental health.

Common Clinical Scenarios

Patients with anxiety or sleep disorders who misuse sedatives or anxiolytics.

Billing Considerations

Documentation of any psychiatric comorbidities and their relationship to substance use.

Coding Guidelines

Inclusion Criteria

Use F13.120 When
  • According to ICD
  • 10 guidelines, F13
  • 120 should be used when the patient exhibits signs of intoxication without complications
  • Documentation must support the diagnosis, including the type of substance and the context of use

Exclusion Criteria

Do NOT use F13.120 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

H0001CPT Code

Behavioral health assessment

Clinical Scenario

Used when assessing a patient for substance use disorders.

Documentation Requirements

Complete assessment documentation including history and mental status.

Specialty Considerations

Addiction specialists should ensure comprehensive evaluations are performed.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of substance use disorders, improving the ability to track and treat these conditions effectively. F13.120 provides a clear designation for uncomplicated intoxication, aiding in treatment planning and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of substance use disorders, improving the ability to track and treat these conditions effectively. F13.120 provides a clear designation for uncomplicated intoxication, aiding in treatment planning and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of substance use disorders, improving the ability to track and treat these conditions effectively. F13.120 provides a clear designation for uncomplicated intoxication, aiding in 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 F13.120 and F13.121?

F13.120 is used for uncomplicated intoxication, while F13.121 is for cases where complications arise, such as respiratory distress or other medical issues.