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ICD-10 Guide
ICD-10 CodesF13.99

F13.99

Billable

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

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

Code Description

ICD-10 F13.99 is a billable code used to indicate a diagnosis of sedative, hypnotic or anxiolytic use, unspecified with unspecified sedative, hypnotic or anxiolytic-induced disorder.

Key Diagnostic Point:

F13.99 refers to a condition characterized by the use of sedatives, hypnotics, or anxiolytics that leads to an unspecified disorder. This code encompasses a range of issues related to substance use disorders, including addiction, withdrawal symptoms, and intoxication. Patients may present with various symptoms such as anxiety, insomnia, or agitation, which can complicate their clinical picture. The unspecified nature of the code indicates that the specific substance involved is not documented, making it essential for healthcare providers to conduct thorough assessments to identify the substance and its effects. Treatment may involve detoxification, counseling, and rehabilitation programs tailored to the individual's needs. Understanding the nuances of this code is crucial for accurate documentation and appropriate treatment planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Unspecified nature of the sedative, hypnotic, or anxiolytic involved
  • Variety of potential withdrawal symptoms and their management
  • Need for comprehensive patient history to determine substance use
  • Differentiation between use, misuse, and dependence

Audit Risk Factors

  • Inadequate documentation of substance use history
  • Failure to specify the substance involved
  • Misclassification of withdrawal symptoms
  • Lack of evidence for treatment provided

Specialty Focus

Medical Specialties

Addiction Medicine

Documentation Requirements

Detailed patient history, including substance use patterns and treatment responses.

Common Clinical Scenarios

Patients presenting with withdrawal symptoms or seeking treatment for substance use.

Billing Considerations

Consideration of co-occurring mental health disorders and comprehensive treatment plans.

Psychiatry

Documentation Requirements

Thorough psychiatric evaluation and documentation of mental health history.

Common Clinical Scenarios

Patients with anxiety or sleep disorders exacerbated by substance use.

Billing Considerations

Assessment of the impact of substance use on mental health and treatment outcomes.

Coding Guidelines

Inclusion Criteria

Use F13.99 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the patient's substance use history and symptoms
  • induced disorders if the substance is known

Exclusion Criteria

Do NOT use F13.99 When
  • Exclude codes for specific sedative, hypnotic, or anxiolytic

Related ICD-10 Codes

Related CPT Codes

H0031CPT Code

Mental health assessment

Clinical Scenario

Used when assessing a patient for substance use disorder.

Documentation Requirements

Document the assessment findings and treatment plan.

Specialty Considerations

Ensure alignment 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, but it has also increased the complexity of documentation requirements. Coders must ensure they are accurately capturing the patient's condition to avoid denials and ensure appropriate reimbursement.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of substance use disorders, but it has also increased the complexity of documentation requirements. Coders must ensure they are accurately capturing the patient's condition to avoid denials and ensure appropriate reimbursement.

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 should I document to support the use of F13.99?

Document the patient's substance use history, symptoms, treatment provided, and any co-occurring mental health disorders to support the use of this code.