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ICD-10 Guide
ICD-10 CodesF19.230

F19.230

Billable

Other psychoactive substance dependence with withdrawal, uncomplicated

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

Code Description

ICD-10 F19.230 is a billable code used to indicate a diagnosis of other psychoactive substance dependence with withdrawal, uncomplicated.

Key Diagnostic Point:

F19.230 refers to a diagnosis of dependence on other psychoactive substances, characterized by a pattern of compulsive use despite harmful consequences, and the presence of withdrawal symptoms when the substance is reduced or discontinued. This code is used when the withdrawal symptoms are uncomplicated, meaning they do not require hospitalization or intensive medical intervention. Common substances that may fall under this category include synthetic cannabinoids, hallucinogens, and other non-specified psychoactive substances. Clinically, patients may present with symptoms such as anxiety, irritability, insomnia, and physical symptoms like tremors or sweating. Treatment typically involves supportive care, counseling, and possibly medication to manage withdrawal symptoms. It is crucial for healthcare providers to document the specific substance involved, the severity of dependence, and the withdrawal symptoms to ensure accurate coding and appropriate treatment planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of substances classified under 'other psychoactive substances'
  • Need for detailed documentation of withdrawal symptoms
  • Differentiation from other substance use disorders
  • Potential for co-occurring mental health conditions

Audit Risk Factors

  • Inadequate documentation of withdrawal symptoms
  • Failure to specify the psychoactive substance involved
  • Misclassification of uncomplicated withdrawal as complicated
  • Lack of evidence for treatment provided

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, requiring outpatient management.

Billing Considerations

Ensure accurate documentation of the specific substance and severity of dependence.

Psychiatry

Documentation Requirements

Comprehensive psychiatric evaluation, including mental health history and current symptoms.

Common Clinical Scenarios

Patients with co-occurring mental health disorders and substance dependence.

Billing Considerations

Document any psychiatric interventions or medications prescribed for withdrawal management.

Coding Guidelines

Inclusion Criteria

Use F19.230 When
  • According to ICD
  • 10 guidelines, F19
  • 230 should be used when there is evidence of dependence on a psychoactive substance with uncomplicated withdrawal
  • Coders must ensure that the diagnosis is supported by clinical documentation and that the withdrawal symptoms are clearly outlined

Exclusion Criteria

Do NOT use F19.230 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99406CPT Code

Smoking and tobacco use cessation counseling visit

Clinical Scenario

Used for patients receiving counseling for substance dependence.

Documentation Requirements

Document the counseling session details and patient progress.

Specialty Considerations

Addiction specialists may use this code frequently in conjunction with F19.230.

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, including F19.230, which helps in better tracking and management of these conditions. It provides a clearer understanding of the patient's condition and treatment needs.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of substance use disorders, including F19.230, which helps in better tracking and management of these conditions. It provides a clearer understanding of the patient's condition and treatment needs.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of substance use disorders, including F19.230, which helps in better tracking and management of these conditions. It provides a clearer understanding of the patient's condition and treatment needs.

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 types of substances are included under F19.230?

F19.230 includes dependence on various psychoactive substances not specifically classified elsewhere, such as synthetic cannabinoids, hallucinogens, and other non-specified substances.