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ICD-10 Guide
ICD-10 CodesF13.92

F13.92

Billable

Sedative, hypnotic or anxiolytic use, unspecified with intoxication

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

Code Description

ICD-10 F13.92 is a billable code used to indicate a diagnosis of sedative, hypnotic or anxiolytic use, unspecified with intoxication.

Key Diagnostic Point:

F13.92 refers to the condition where an individual is experiencing intoxication due to the use of sedatives, hypnotics, or anxiolytics, but the specific substance is not identified. This condition is characterized by a range of symptoms including drowsiness, confusion, impaired coordination, and decreased cognitive function. The intoxication can lead to significant impairment in social, occupational, or other important areas of functioning. Individuals may present with slurred speech, unsteady gait, and altered mental status. The diagnosis is crucial as it indicates the need for immediate medical intervention to manage the intoxication and prevent potential complications such as respiratory depression or overdose. Treatment typically involves supportive care, monitoring vital signs, and in severe cases, the administration of antidotes or interventions to reverse the effects of the sedative or anxiolytic. Understanding the nuances of this diagnosis is essential for effective treatment and management of substance use disorders.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Unspecified nature of the substance complicates treatment planning.
  • Varied presentation of symptoms can lead to misdiagnosis.
  • Need for comprehensive patient history to determine substance use.
  • Potential for co-occurring disorders requiring additional coding.

Audit Risk Factors

  • Inadequate documentation of intoxication symptoms.
  • Failure to specify the substance used when known.
  • Lack of evidence for medical necessity of treatment.
  • Inconsistent coding with clinical notes.

Specialty Focus

Medical Specialties

Addiction Medicine

Documentation Requirements

Detailed patient history, including substance use patterns and previous treatment attempts.

Common Clinical Scenarios

Patients presenting with overdose symptoms, withdrawal management, or relapse.

Billing Considerations

Consideration of co-occurring mental health disorders and their impact on treatment.

Emergency Medicine

Documentation Requirements

Immediate assessment of vital signs, level of consciousness, and substance identification if possible.

Common Clinical Scenarios

Patients arriving via ambulance with altered mental status or respiratory distress.

Billing Considerations

Rapid intervention protocols and documentation of emergency measures taken.

Coding Guidelines

Inclusion Criteria

Use F13.92 When
  • According to ICD
  • 10 coding guidelines, F13
  • 92 should be used when there is evidence of intoxication from sedatives, hypnotics, or anxiolytics without specification of the substance
  • It is important to document the clinical presentation and any interventions provided

Exclusion Criteria

Do NOT use F13.92 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99284CPT Code

Emergency department visit, high severity.

Clinical Scenario

Used when a patient presents with severe intoxication symptoms.

Documentation Requirements

Must document the severity of symptoms and interventions performed.

Specialty Considerations

Emergency medicine specialists should ensure thorough documentation of the patient's condition.

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 intoxication. This specificity aids in better tracking of treatment outcomes and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of substance use disorders, including intoxication. This specificity aids in better tracking of treatment outcomes and resource allocation.

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 F13.92 and F13.90?

F13.92 specifies intoxication due to sedative, hypnotic, or anxiolytic use, while F13.90 is used for unspecified use without intoxication.