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v1.0.0
ICD-10 Guide
ICD-10 CodesF14.1

F14.1

Billable

Cocaine abuse

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

Code Description

ICD-10 F14.1 is a billable code used to indicate a diagnosis of cocaine abuse.

Key Diagnostic Point:

Cocaine abuse is characterized by the recurrent use of cocaine, leading to significant impairment or distress. This condition is classified under substance use disorders in the ICD-10 coding system. Cocaine, a powerful stimulant, can lead to a range of physical and psychological issues, including increased energy, euphoria, and heightened alertness, but also anxiety, paranoia, and cardiovascular complications. The diagnosis of cocaine abuse is made when an individual exhibits a pattern of cocaine use that results in failure to fulfill major role obligations, use in hazardous situations, legal problems, and continued use despite social or interpersonal problems. Withdrawal symptoms may include fatigue, increased appetite, depression, and vivid dreams. Treatment often involves behavioral therapies, counseling, and support groups, as there are currently no FDA-approved medications specifically for cocaine addiction. Understanding the nuances of cocaine abuse is essential for accurate coding and effective treatment planning.

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 use disorders
  • Potential for co-occurring mental health disorders

Audit Risk Factors

  • Inadequate documentation of substance use history
  • Failure to document co-occurring mental health conditions
  • Misclassification of cocaine abuse versus dependence
  • Lack of evidence for treatment interventions

Specialty Focus

Medical Specialties

Addiction Medicine

Documentation Requirements

Detailed history of substance use, treatment history, and psychosocial factors.

Common Clinical Scenarios

Patients presenting with withdrawal symptoms, seeking detoxification, or entering rehabilitation programs.

Billing Considerations

Documentation must reflect the severity of abuse and any co-occurring disorders for accurate coding.

Psychiatry

Documentation Requirements

Comprehensive mental health evaluation, including assessment of mood, anxiety, and cognitive function.

Common Clinical Scenarios

Patients with cocaine abuse presenting with anxiety, depression, or psychosis.

Billing Considerations

Consideration of the impact of cocaine on mental health and the need for integrated treatment plans.

Coding Guidelines

Inclusion Criteria

Use F14.1 When
  • Follow ICD
  • CM guidelines for substance use disorders, ensuring accurate documentation of the patient's history, symptoms, and treatment plans
  • Include any relevant co
  • occurring conditions

Exclusion Criteria

Do NOT use F14.1 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

H0001CPT Code

Assessment of substance use disorder

Clinical Scenario

Used when evaluating a patient for cocaine abuse in an outpatient setting.

Documentation Requirements

Document the assessment findings, including substance use history and mental health evaluation.

Specialty Considerations

Addiction specialists should ensure comprehensive evaluations are conducted.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of cocaine-related disorders, improving the ability to track and manage substance use disorders effectively.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of cocaine-related disorders, improving the ability to track and manage substance use disorders effectively.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of cocaine-related disorders, improving the ability to track and manage substance use disorders 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 difference between cocaine abuse and cocaine dependence?

Cocaine abuse refers to the harmful use of cocaine without the presence of physical dependence, while cocaine dependence includes criteria such as tolerance and withdrawal symptoms.