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ICD-10 Guide
ICD-10 CodesF13.931

F13.931

Billable

Sedative, hypnotic or anxiolytic use, unspecified with withdrawal delirium

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

Code Description

ICD-10 F13.931 is a billable code used to indicate a diagnosis of sedative, hypnotic or anxiolytic use, unspecified with withdrawal delirium.

Key Diagnostic Point:

F13.931 refers to a condition characterized by the use of sedative, hypnotic, or anxiolytic substances leading to withdrawal delirium. This condition arises when an individual who has developed a dependence on these substances suddenly reduces or stops their intake, resulting in severe psychological and physiological symptoms. Withdrawal delirium can manifest as confusion, agitation, hallucinations, and autonomic instability, which may require immediate medical intervention. The diagnosis is often made based on the patient's history of substance use, clinical presentation, and the exclusion of other potential causes of delirium. Treatment typically involves supportive care, monitoring, and possibly pharmacological interventions to manage symptoms. Understanding the nuances of this diagnosis is crucial for effective treatment and accurate coding, as it reflects the complexities of substance use disorders and the challenges faced by healthcare providers in managing withdrawal symptoms.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Variety of substances that can lead to similar withdrawal symptoms
  • Need for comprehensive patient history to confirm substance use
  • Differentiation from other types of delirium or mental health disorders
  • Potential for co-occurring substance use disorders

Audit Risk Factors

  • Inadequate documentation of substance use history
  • Failure to document withdrawal symptoms clearly
  • Misclassification of withdrawal delirium as another condition
  • Lack of evidence for the severity of symptoms

Specialty Focus

Medical Specialties

Psychiatry

Documentation Requirements

Detailed patient history, including substance use patterns and withdrawal symptoms.

Common Clinical Scenarios

Patients presenting with acute confusion and agitation after cessation of sedative use.

Billing Considerations

Consideration of co-occurring mental health disorders and the need for a comprehensive treatment plan.

Addiction Medicine

Documentation Requirements

Thorough assessment of substance use history and current withdrawal symptoms.

Common Clinical Scenarios

Patients in detoxification programs experiencing withdrawal delirium.

Billing Considerations

Integration of behavioral therapies and pharmacological management in treatment plans.

Coding Guidelines

Inclusion Criteria

Use F13.931 When
  • According to ICD
  • 10 guidelines, F13
  • 931 should be used when there is clear evidence of sedative, hypnotic, or anxiolytic use leading to withdrawal delirium
  • Documentation must support the diagnosis, including the patient's substance use history and clinical presentation

Exclusion Criteria

Do NOT use F13.931 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99214CPT Code

Established patient office visit, level 4

Clinical Scenario

Used when managing a patient with withdrawal symptoms in an outpatient setting.

Documentation Requirements

Document the patient's history, examination findings, and treatment plan.

Specialty Considerations

Psychiatric evaluations may require additional documentation of mental status.

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 withdrawal symptoms, which enhances the ability to track and manage these conditions effectively.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of substance use disorders, including withdrawal symptoms, which enhances the ability to track and manage these conditions effectively.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of substance use disorders, including withdrawal symptoms, which enhances the ability to track and manage these conditions effectively.

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 significance of documenting withdrawal symptoms?

Documenting withdrawal symptoms is crucial for accurate coding and treatment planning. It helps differentiate between withdrawal delirium and other conditions, ensuring appropriate care and reimbursement.