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ICD-10 Guide
ICD-10 CodesF13.129

F13.129

Billable

Sedative, hypnotic or anxiolytic abuse with intoxication, unspecified

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

Code Description

ICD-10 F13.129 is a billable code used to indicate a diagnosis of sedative, hypnotic or anxiolytic abuse with intoxication, unspecified.

Key Diagnostic Point:

F13.129 refers to the abuse of sedative, hypnotic, or anxiolytic substances, characterized by a pattern of consumption that leads to significant impairment or distress. This code specifically indicates that the individual is experiencing intoxication from these substances, which can include medications such as benzodiazepines and barbiturates. Symptoms of intoxication may include drowsiness, confusion, impaired coordination, and respiratory depression. The diagnosis of abuse is established when the individual exhibits a maladaptive pattern of use, leading to recurrent social, occupational, or legal problems. The unspecified nature of this code indicates that the specific substance causing the abuse is not documented, which can complicate treatment and management strategies. Treatment typically involves detoxification, counseling, and support groups, focusing on both the physical and psychological aspects of addiction. Understanding the nuances of this diagnosis is crucial for effective treatment planning and coding accuracy.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in documentation of substance type and quantity
  • Differentiating between abuse and dependence
  • Need for comprehensive patient history
  • Potential for co-occurring mental health disorders

Audit Risk Factors

  • Inadequate documentation of substance use history
  • Failure to specify the substance involved
  • Misclassification of abuse versus dependence
  • Lack of evidence for intoxication symptoms

Specialty Focus

Medical Specialties

Addiction Medicine

Documentation Requirements

Detailed substance use history, including types and amounts of substances used, duration of use, and impact on daily functioning.

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 disorders using anxiolytics excessively or those with depressive symptoms using sedatives.

Billing Considerations

Importance of distinguishing between primary psychiatric disorders and substance-induced symptoms.

Coding Guidelines

Inclusion Criteria

Use F13.129 When
  • According to ICD
  • 10 coding guidelines, F13
  • 129 should be used when there is clear documentation of sedative, hypnotic, or anxiolytic abuse with intoxication, and when the specific substance is not identified
  • Coders should ensure that the documentation supports the diagnosis and reflects the severity of the condition

Exclusion Criteria

Do NOT use F13.129 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

H0031CPT Code

Mental health assessment

Clinical Scenario

Used when assessing a patient for substance use disorder.

Documentation Requirements

Comprehensive assessment notes detailing substance use history and current symptoms.

Specialty Considerations

Addiction specialists should ensure thorough documentation of all relevant factors.

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, including the ability to differentiate between abuse and dependence. This specificity aids in better 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, including the ability to differentiate between abuse and dependence. This specificity aids in better treatment planning and resource allocation.

Reimbursement & Billing Impact

impact on their daily functioning. Providers should ensure that all relevant information is included to support the diagnosis and treatment provided.

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 F13.129 and F13.120?

F13.129 refers to abuse with intoxication, while F13.120 indicates dependence. Dependence involves a more severe level of substance use disorder, often requiring different treatment approaches.