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ICD-10 Guide
ICD-10 CodesF19.130

F19.130

Billable

Other psychoactive substance abuse with withdrawal, uncomplicated

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

Code Description

ICD-10 F19.130 is a billable code used to indicate a diagnosis of other psychoactive substance abuse with withdrawal, uncomplicated.

Key Diagnostic Point:

F19.130 refers to the diagnosis of uncomplicated withdrawal from other psychoactive substances, which may include a variety of substances not specifically classified under other categories. Patients may experience withdrawal symptoms that can range from mild to moderate, including anxiety, irritability, insomnia, and physical symptoms such as tremors or gastrointestinal distress. The diagnosis is crucial as it indicates the need for appropriate management and treatment strategies to support the patient through the withdrawal process. Treatment may involve supportive care, counseling, and possibly pharmacotherapy to alleviate withdrawal symptoms. It is essential for healthcare providers to assess the patient's substance use history, the severity of withdrawal symptoms, and any co-occurring mental health disorders to tailor an effective treatment plan. Accurate coding is vital for ensuring that patients receive the necessary care and for proper reimbursement for services rendered.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of substances that can fall under 'other psychoactive substances'
  • Need for thorough documentation of withdrawal symptoms and history
  • Potential for co-occurring mental health disorders
  • Variability in withdrawal symptom severity

Audit Risk Factors

  • Inadequate documentation of withdrawal symptoms
  • Failure to document substance use history
  • Misclassification of the substance causing withdrawal
  • Lack of evidence for uncomplicated withdrawal

Specialty Focus

Medical Specialties

Addiction Medicine

Documentation Requirements

Detailed history of substance use, withdrawal symptoms, and treatment plan.

Common Clinical Scenarios

Patients presenting with withdrawal symptoms after cessation of use of non-specific psychoactive substances.

Billing Considerations

Consideration of co-occurring mental health disorders and the need for a multidisciplinary approach.

Psychiatry

Documentation Requirements

Comprehensive psychiatric evaluation, including mental status examination and risk assessment.

Common Clinical Scenarios

Patients with a history of substance abuse presenting with anxiety or mood disturbances during withdrawal.

Billing Considerations

Monitoring for potential complications and the need for psychiatric intervention.

Coding Guidelines

Inclusion Criteria

Use F19.130 When
  • Follow ICD
  • CM guidelines for coding substance use disorders, ensuring accurate documentation of withdrawal symptoms and substance history
  • induced disorders unless applicable

Exclusion Criteria

Do NOT use F19.130 When
  • Exclude codes for substance

Related ICD-10 Codes

Related CPT Codes

99406CPT Code

Smoking and tobacco use cessation counseling visit

Clinical Scenario

Used in conjunction with F19.130 for patients undergoing withdrawal from tobacco.

Documentation Requirements

Document the counseling session and patient progress.

Specialty Considerations

Addiction specialists may provide additional support.

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 manage these conditions effectively.

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 manage these conditions effectively.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of substance use disorders, improving the ability to track and manage these conditions 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 are the common withdrawal symptoms associated with F19.130?

Common withdrawal symptoms may include anxiety, irritability, insomnia, tremors, and gastrointestinal distress. The severity can vary based on the substance used and the individual's history.