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ICD-10 Guide
ICD-10 CodesF13.22

F13.22

Billable

Sedative, hypnotic or anxiolytic dependence with intoxication

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

Code Description

ICD-10 F13.22 is a billable code used to indicate a diagnosis of sedative, hypnotic or anxiolytic dependence with intoxication.

Key Diagnostic Point:

F13.22 refers to a clinical condition characterized by a pattern of sedative, hypnotic, or anxiolytic substance use that leads to significant impairment or distress. This diagnosis indicates that the individual has developed a dependence on these substances, which can include medications such as benzodiazepines or barbiturates. Dependence is marked by a strong desire to consume the substance, difficulty in controlling its use, and the presence of withdrawal symptoms when not using. Intoxication occurs when the individual consumes a quantity that leads to altered mental status, impaired judgment, or physical coordination. The combination of dependence and intoxication can lead to serious health risks, including overdose, which may require emergency intervention. Treatment typically involves a comprehensive approach, including detoxification, counseling, and support groups, aimed at addressing both the psychological and physical aspects of addiction.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between dependence and intoxication
  • Need for comprehensive documentation of substance use history
  • Potential for co-occurring mental health disorders
  • Variability in withdrawal symptoms and their documentation

Audit Risk Factors

  • Inadequate documentation of substance use history
  • Failure to document withdrawal symptoms
  • Misclassification of dependence vs. intoxication
  • Lack of evidence for treatment interventions

Specialty Focus

Medical Specialties

Addiction Medicine

Documentation Requirements

Detailed history of substance use, treatment history, and current symptoms.

Common Clinical Scenarios

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

Billing Considerations

Consideration of co-occurring mental health disorders and comprehensive treatment plans.

Psychiatry

Documentation Requirements

Thorough psychiatric evaluation, including mental status examination and risk assessment.

Common Clinical Scenarios

Patients with anxiety disorders using anxiolytics or those with insomnia using sedatives.

Billing Considerations

Monitoring for potential interactions with other psychiatric medications.

Coding Guidelines

Inclusion Criteria

Use F13.22 When
  • According to ICD
  • 10 guidelines, F13
  • 22 should be used when both dependence and intoxication are present
  • Documentation must support the diagnosis, including evidence of substance use patterns and the impact on functioning

Exclusion Criteria

Do NOT use F13.22 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

H0031CPT Code

Mental health assessment

Clinical Scenario

Used during initial evaluation of a patient with suspected substance dependence.

Documentation Requirements

Comprehensive assessment notes including history and mental status.

Specialty Considerations

Addiction specialists may require additional details on substance use history.

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 manage these conditions. F13.22 provides a clear distinction between dependence and intoxication, which is crucial for treatment planning and reimbursement.

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 manage these conditions. F13.22 provides a clear distinction between dependence and intoxication, which is crucial for treatment planning and reimbursement.

Reimbursement & Billing Impact

reimbursement.

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 dependence and intoxication?

Dependence refers to a state where an individual has a strong desire to use a substance and experiences withdrawal symptoms when not using. Intoxication refers to the acute effects of the substance on the body and mind, which can impair functioning.