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ICD-10 Guide
ICD-10 CodesF13.98

F13.98

Billable

Sedative, hypnotic or anxiolytic use, unspecified with other sedative, hypnotic or anxiolytic-induced disorders

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

Code Description

ICD-10 F13.98 is a billable code used to indicate a diagnosis of sedative, hypnotic or anxiolytic use, unspecified with other sedative, hypnotic or anxiolytic-induced disorders.

Key Diagnostic Point:

F13.98 refers to the use of sedative, hypnotic, or anxiolytic substances that leads to unspecified disorders, which may include addiction, withdrawal symptoms, or intoxication. These substances are often prescribed for anxiety, sleep disorders, or other conditions but can lead to misuse and dependency. Patients may present with various symptoms, including cognitive impairment, mood disturbances, and physical health issues. The diagnosis requires a comprehensive assessment of the patient's substance use history, current symptoms, and any co-occurring mental health disorders. Treatment may involve detoxification, counseling, and medication management to address withdrawal symptoms and support recovery. Accurate coding is essential for appropriate treatment planning and reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of symptoms associated with sedative use disorders
  • Potential for co-occurring mental health conditions
  • Need for detailed patient history to determine severity
  • Variability in treatment approaches based on individual patient needs

Audit Risk Factors

  • Inadequate documentation of substance use history
  • Failure to specify the type of sedative or hypnotic used
  • Lack of evidence for treatment interventions
  • Misclassification of withdrawal symptoms

Specialty Focus

Medical Specialties

Addiction Medicine

Documentation Requirements

Comprehensive substance use history, treatment plans, and progress notes.

Common Clinical Scenarios

Patients presenting with withdrawal symptoms, seeking detoxification, or requiring medication-assisted treatment.

Billing Considerations

Ensure documentation reflects the severity of addiction and any co-occurring mental health disorders.

Psychiatry

Documentation Requirements

Detailed psychiatric evaluations, treatment plans, and progress notes regarding mental health status.

Common Clinical Scenarios

Patients with anxiety disorders who misuse sedatives or those experiencing mood disturbances due to substance use.

Billing Considerations

Document any psychiatric evaluations that differentiate between primary mental health disorders and substance-induced conditions.

Coding Guidelines

Inclusion Criteria

Use F13.98 When
  • Follow the ICD
  • CM coding guidelines for substance use disorders, ensuring accurate documentation of the patient's substance use history, current symptoms, and treatment interventions

Exclusion Criteria

Do NOT use F13.98 When
  • Exclude codes for conditions that are not related to sedative, hypnotic, or anxiolytic use

Related ICD-10 Codes

Related CPT Codes

H0031CPT Code

Mental health assessment

Clinical Scenario

Used when assessing a patient for sedative use disorder.

Documentation Requirements

Document the assessment findings and treatment recommendations.

Specialty Considerations

Ensure the assessment aligns with addiction medicine protocols.

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. F13.98 provides a broader category for unspecified disorders, which can help in capturing cases that may not fit neatly into more specific codes.

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. F13.98 provides a broader category for unspecified disorders, which can help in capturing cases that may not fit neatly into more specific codes.

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. F13.98 provides a broader category for unspecified disorders, which can help in capturing cases that may not fit neatly into more specific codes.

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 F13.98 and F13.10?

F13.98 is used for unspecified sedative, hypnotic, or anxiolytic use with other induced disorders, while F13.10 specifically indicates dependence on these substances.