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ICD-10 Guide
ICD-10 CodesF55.3

F55.3

Billable

Abuse of steroids or hormones

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

Code Description

ICD-10 F55.3 is a billable code used to indicate a diagnosis of abuse of steroids or hormones.

Key Diagnostic Point:

Abuse of steroids or hormones refers to the non-medical use of anabolic steroids or hormones for performance enhancement, weight loss, or body image improvement. This behavior is often associated with various psychological and physical health issues, including eating disorders, sleep disorders, sexual dysfunction, and behavioral syndromes. Individuals may misuse these substances to achieve a desired physique or athletic performance, leading to significant health risks. The abuse can result in a range of adverse effects, including mood swings, aggression, depression, and anxiety. Additionally, physical complications such as cardiovascular disease, liver damage, and hormonal imbalances can occur. In the context of eating disorders, individuals may use steroids to accelerate weight loss or muscle gain, exacerbating underlying psychological issues. Sleep disorders may arise due to hormonal imbalances, while sexual dysfunction can manifest as a result of altered testosterone levels. Behavioral syndromes, including increased aggression or compulsive behaviors, are also common among those abusing these substances. Accurate diagnosis and coding are essential for appropriate treatment and management of these complex conditions.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of symptoms associated with abuse
  • Overlap with other mental health disorders
  • Need for comprehensive documentation of substance use history
  • Potential for co-occurring conditions

Audit Risk Factors

  • Inadequate documentation of substance use history
  • Failure to document co-occurring mental health conditions
  • Misclassification of substance abuse severity
  • Lack of evidence for medical necessity of treatment

Specialty Focus

Medical Specialties

Psychiatry

Documentation Requirements

Detailed patient history, including substance use patterns and mental health evaluations.

Common Clinical Scenarios

Patients presenting with mood disorders, anxiety, or aggression linked to steroid abuse.

Billing Considerations

Consideration of underlying mental health disorders and their impact on treatment.

Endocrinology

Documentation Requirements

Hormonal assessments, including testosterone levels and metabolic evaluations.

Common Clinical Scenarios

Patients with hormonal imbalances or metabolic disorders due to steroid use.

Billing Considerations

Monitoring for long-term effects of hormone abuse on endocrine function.

Coding Guidelines

Inclusion Criteria

Use F55.3 When
  • According to ICD
  • 10 guidelines, F55
  • 3 should be used when there is clear evidence of steroid or hormone abuse without a medical indication
  • Documentation must support the diagnosis, including patient history and clinical findings

Exclusion Criteria

Do NOT use F55.3 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99214CPT Code

Established patient office visit, level 4

Clinical Scenario

Used for follow-up visits for patients with steroid abuse.

Documentation Requirements

Document history, examination findings, and treatment plan.

Specialty Considerations

Psychiatric evaluations may require additional documentation.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of steroid and hormone abuse, 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 steroid and hormone abuse, 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 steroid and hormone abuse, 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 is the primary focus of F55.3 coding?

F55.3 focuses on the non-medical abuse of steroids or hormones, emphasizing the psychological and physical health implications of such abuse.