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ICD-10 Guide
ICD-10 CodesF13.94

F13.94

Billable

Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced mood disorder

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

Code Description

ICD-10 F13.94 is a billable code used to indicate a diagnosis of sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced mood disorder.

Key Diagnostic Point:

F13.94 refers to a condition characterized by the use of sedative, hypnotic, or anxiolytic substances that leads to a mood disorder. This code is used when the specific substance is not identified, but the patient exhibits symptoms of mood disturbance as a result of their substance use. Sedatives, hypnotics, and anxiolytics are commonly prescribed for anxiety, insomnia, and other related conditions. However, misuse or prolonged use can lead to dependence, withdrawal symptoms, and mood disorders such as depression or anxiety. Clinicians must assess the patient's substance use history, current symptoms, and any co-occurring mental health disorders to provide appropriate treatment. Treatment may involve detoxification, counseling, and medication management to address both the substance use disorder and the mood disorder. Accurate coding is essential for proper treatment planning and reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Unspecified nature of substance use complicates diagnosis.
  • Requires comprehensive documentation of mood disorder symptoms.
  • Potential overlap with other substance use disorders.
  • Need for detailed patient history to determine severity and treatment.

Audit Risk Factors

  • Inadequate documentation of substance use history.
  • Failure to specify the mood disorder symptoms.
  • Misclassification of substance use severity.
  • Lack of evidence for treatment provided.

Specialty Focus

Medical Specialties

Psychiatry

Documentation Requirements

Detailed patient history, including substance use and mood symptoms.

Common Clinical Scenarios

Patients presenting with anxiety or depression linked to substance use.

Billing Considerations

Consideration of co-occurring disorders and comprehensive treatment plans.

Addiction Medicine

Documentation Requirements

Thorough assessment of substance use patterns and withdrawal symptoms.

Common Clinical Scenarios

Patients undergoing detoxification with mood disturbances.

Billing Considerations

Focus on integrated treatment approaches for substance use and mood disorders.

Coding Guidelines

Inclusion Criteria

Use F13.94 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the patient's substance use history and mood disorder symptoms
  • Include any relevant laboratory results or assessments that support the diagnosis

Exclusion Criteria

Do NOT use F13.94 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 and mood disorders.

Documentation Requirements

Comprehensive assessment notes and treatment plan.

Specialty Considerations

Psychiatric evaluations should include 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 treat these conditions effectively. F13.94 provides a clear framework for identifying patients with mood disorders related to sedative, hypnotic, or anxiolytic use.

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 treat these conditions effectively. F13.94 provides a clear framework for identifying patients with mood disorders related to sedative, hypnotic, or anxiolytic use.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of substance use disorders, improving the ability to track and treat these conditions effectively. F13.94 provides a clear framework for identifying patients with mood disorders related to sedative, hypnotic, or anxiolytic use.

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 using F13.94?

F13.94 is significant as it captures the relationship between sedative, hypnotic, or anxiolytic use and mood disorders, allowing for targeted treatment and better understanding of patient needs.