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ICD-10 Guide
ICD-10 CodesF19.231

F19.231

Billable

Other psychoactive substance dependence with withdrawal delirium

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

Code Description

ICD-10 F19.231 is a billable code used to indicate a diagnosis of other psychoactive substance dependence with withdrawal delirium.

Key Diagnostic Point:

F19.231 refers to a diagnosis of dependence on other psychoactive substances, characterized by the presence of withdrawal delirium. This condition arises when an individual has developed a physical and psychological dependence on substances not classified under the more common categories such as alcohol, opioids, or stimulants. Withdrawal delirium is a severe form of withdrawal syndrome that can manifest as confusion, agitation, hallucinations, and autonomic instability. Patients may experience significant distress and impairment in social, occupational, or other important areas of functioning. The diagnosis requires careful assessment of the patient's substance use history, clinical presentation, and the timing of withdrawal symptoms in relation to substance cessation. Treatment typically involves a combination of pharmacological interventions to manage withdrawal symptoms and psychological support to address the underlying substance use disorder. Comprehensive treatment programs may include inpatient detoxification, outpatient therapy, and support groups to promote recovery and prevent relapse.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Variety of psychoactive substances that can lead to dependence
  • Need for thorough documentation of withdrawal symptoms
  • 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 specific withdrawal symptoms
  • Misclassification of the type of substance used
  • Lack of evidence for the severity of dependence

Specialty Focus

Medical Specialties

Addiction Medicine

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with acute withdrawal symptoms, requiring detoxification.

Billing Considerations

Ensure comprehensive assessment of all substances used and their impact on the patient's health.

Psychiatry

Documentation Requirements

Mental status examination, assessment of co-occurring disorders, and treatment response.

Common Clinical Scenarios

Patients with dual diagnoses of substance use disorder and mental health conditions.

Billing Considerations

Documenting the interplay between substance use and psychiatric symptoms is crucial.

Coding Guidelines

Inclusion Criteria

Use F19.231 When
  • According to ICD
  • 10 coding guidelines, F19
  • 231 should be used when there is clear evidence of dependence on a psychoactive substance accompanied by withdrawal delirium
  • Coders must ensure that documentation supports the diagnosis, including specific withdrawal symptoms and their severity

Exclusion Criteria

Do NOT use F19.231 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

H0031CPT Code

Mental health assessment

Clinical Scenario

Used when assessing a patient for substance dependence and withdrawal symptoms.

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, including the ability to capture withdrawal delirium as a distinct condition. This specificity aids in better treatment planning and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of substance use disorders, including the ability to capture withdrawal delirium as a distinct condition. This specificity aids in better treatment planning and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of substance use disorders, including the ability to capture withdrawal delirium as a distinct condition. This specificity aids in better treatment planning and resource allocation.

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 key symptoms of withdrawal delirium?

Key symptoms include confusion, agitation, hallucinations, and autonomic instability, which can be life-threatening if not managed properly.