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ICD-10 Guide
ICD-10 CodesF13.921

F13.921

Billable

Sedative, hypnotic or anxiolytic use, unspecified with intoxication delirium

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

Code Description

ICD-10 F13.921 is a billable code used to indicate a diagnosis of sedative, hypnotic or anxiolytic use, unspecified with intoxication delirium.

Key Diagnostic Point:

F13.921 refers to a condition characterized by the use of sedatives, hypnotics, or anxiolytics that leads to intoxication delirium. This condition is often seen in individuals who misuse these substances, which can include benzodiazepines, barbiturates, and other medications that depress the central nervous system. Intoxication delirium manifests as confusion, altered consciousness, and cognitive impairment, which can pose significant risks to the individual’s safety and well-being. The diagnosis is typically made based on clinical evaluation, including a thorough history of substance use, physical examination, and assessment of mental status. Treatment may involve supportive care, monitoring, and potentially the use of medications to manage symptoms. Understanding the nuances of this diagnosis is crucial for effective treatment and management of substance use disorders, as well as for accurate coding and billing practices.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in patient presentation and symptoms
  • Need for comprehensive documentation of substance use history
  • Differentiation from other substance-related disorders
  • Potential for co-occurring mental health conditions

Audit Risk Factors

  • Inadequate documentation of substance use history
  • Failure to document the presence of delirium symptoms
  • Misclassification of intoxication severity
  • Lack of evidence for treatment provided

Specialty Focus

Medical Specialties

Psychiatry

Documentation Requirements

Detailed history of substance use, mental status examination, and treatment plan.

Common Clinical Scenarios

Patients presenting with acute confusion and a history of sedative use.

Billing Considerations

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

Addiction Medicine

Documentation Requirements

Comprehensive assessment of substance use patterns and withdrawal symptoms.

Common Clinical Scenarios

Patients undergoing detoxification from sedatives with delirium.

Billing Considerations

Monitoring for withdrawal symptoms and potential complications.

Coding Guidelines

Inclusion Criteria

Use F13.921 When
  • According to ICD
  • 10 coding guidelines, F13
  • 921 should be used when a patient presents with intoxication delirium due to sedative, hypnotic, or anxiolytic use without a specified substance
  • Documentation must support the diagnosis, including evidence of intoxication and cognitive impairment

Exclusion Criteria

Do NOT use F13.921 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99223CPT Code

Initial hospital care, typically 70 minutes or more

Clinical Scenario

Used when a patient is admitted for management of intoxication delirium.

Documentation Requirements

Comprehensive history and examination, including mental status assessment.

Specialty Considerations

Psychiatric evaluation may be necessary for accurate diagnosis.

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. F13.921 provides a clear framework for identifying patients with intoxication delirium, facilitating better treatment 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 manage these conditions. F13.921 provides a clear framework for identifying patients with intoxication delirium, facilitating better treatment 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 manage these conditions. F13.921 provides a clear framework for identifying patients with intoxication delirium, facilitating better treatment 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 F13.921 and F13.920?

F13.921 includes the presence of intoxication delirium, while F13.920 does not specify any acute symptoms or cognitive impairment.