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ICD-10 Guide
ICD-10 CodesF14.12

F14.12

Billable

Cocaine abuse with intoxication

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

Code Description

ICD-10 F14.12 is a billable code used to indicate a diagnosis of cocaine abuse with intoxication.

Key Diagnostic Point:

Cocaine abuse with intoxication refers to a pattern of cocaine use that leads to significant impairment or distress, characterized by the recent consumption of cocaine resulting in intoxication. Cocaine is a powerful central nervous system stimulant that can lead to euphoria, increased energy, and heightened alertness. However, it can also cause adverse effects such as anxiety, paranoia, and cardiovascular complications. The diagnosis of cocaine abuse with intoxication requires evidence of recurrent use leading to clinically significant impairment or distress, including failure to fulfill major role obligations, legal problems, or social and interpersonal issues. Symptoms of intoxication may include increased heart rate, dilated pupils, elevated blood pressure, and hyperactivity. Treatment often involves behavioral therapies, counseling, and support groups, as well as medical management for withdrawal symptoms and complications. Understanding the nuances of this diagnosis is crucial for effective treatment and accurate coding.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between abuse and dependence
  • Identifying specific symptoms of intoxication
  • Documenting the severity of impairment
  • Understanding co-occurring mental health disorders

Audit Risk Factors

  • Inadequate documentation of intoxication symptoms
  • Failure to document the impact on daily functioning
  • Misclassification of cocaine use disorder severity
  • Lack of evidence for treatment interventions

Specialty Focus

Medical Specialties

Addiction Medicine

Documentation Requirements

Comprehensive assessment of substance use history, current symptoms, and treatment plan.

Common Clinical Scenarios

Patients presenting with acute intoxication, withdrawal symptoms, or complications from cocaine use.

Billing Considerations

Ensure documentation reflects the severity of the disorder and any co-occurring mental health issues.

Psychiatry

Documentation Requirements

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

Common Clinical Scenarios

Patients with co-occurring psychiatric disorders and cocaine abuse.

Billing Considerations

Document any psychiatric evaluations and treatment plans that address both substance use and mental health.

Coding Guidelines

Inclusion Criteria

Use F14.12 When
  • According to ICD
  • 10 coding guidelines, F14
  • 12 should be used when there is evidence of cocaine abuse with current intoxication
  • Documentation must support the diagnosis, including symptoms and their impact on the patient's life

Exclusion Criteria

Do NOT use F14.12 When
  • Exclusion criteria include cases where the intoxication is not linked to abuse

Related ICD-10 Codes

Related CPT Codes

H0001CPT Code

Assessment of substance use disorder

Clinical Scenario

Used during initial evaluation of a patient with cocaine abuse.

Documentation Requirements

Document the assessment findings and treatment recommendations.

Specialty Considerations

Addiction specialists should ensure comprehensive evaluations are performed.

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 conditions like cocaine abuse with intoxication. This specificity aids in better resource allocation and treatment planning.

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 conditions like cocaine abuse with intoxication. This specificity aids in better resource allocation and treatment planning.

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 conditions like cocaine abuse with intoxication. This specificity aids in better resource allocation and treatment planning.

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 leading to significant impairment or distress, while cocaine dependence indicates a more severe condition characterized by tolerance, withdrawal symptoms, and compulsive use.