# Alcohol Dependence in Remission F10.21



## nadineguiliano (May 19, 2017)

Please help,
I am confused, if a patient was previously diagnosed with alcohol dependence but is now sober how long can the code for remission be used? Is this code and indefinite use code? I have a patient sober 30 years and providers want to bill Dependence in Remission stating once dependent always dependent. Is this appropriate and if so does that follow for ALL dependence diagnosis? Thank you


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## CodingKing (May 19, 2017)

It usually depends if there is a History of code or not. For instance, if you look in the index for personal history of alcohol dependence it will route you back to the dependence in remission code


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## CJTrujillo (May 19, 2017)

I would refer you to the Chapter 5 guidelines in the ICD-10 book, it states "requires a provider's clinical judgment."  and "assigned only on the basis of provider documentation".  The length of time this code can be used is not spelled out. 

If the documentation substantiates the condition, then it shouldn't be a problem.


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## dianeld (May 25, 2017)

*dependence in remission*

coding is based on physician's clinical judgement.......if they document dependence in remission than you can code it


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## CodingKing (May 25, 2017)

CJTrujillo said:


> I would refer you to the Chapter 5 guidelines in the ICD-10 book, it states "requires a provider's clinical judgment."  and "assigned only on the basis of provider documentation".  The length of time this code can be used is not spelled out.
> 
> If the documentation substantiates the condition, then it shouldn't be a problem.





dianeld said:


> coding is based on physician's clinical judgement.......if they document dependence in remission than you can code it



For this one, no matter how the physician lists it in this is the same code. There is no personal history of Alcohol Dependence that I could find. It all points to in remission in the index.


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## CBondurant1226 (Mar 9, 2018)

*Auditor*

Alcohol dependence is physiologically different than alcohol abuse. 

Chuck Rice, a licensed alcohol and drug abuse counselor at Hazelden and an adjunct assistant professor in Hazelden's Graduate School of Addiction Studies in Center City, Minn., makes three points that can help you further understand the nature of alcohol abuse and dependence.

First, these diagnoses are points on a single continuum. In fact, a common scenario is for drinkers to move from casual alcohol use to abuse and then to dependence. "In plain English, the difference is really a matter of degree," says Rice. "When drinkers start having tolerance and withdrawal, they are at a point where they move into dependence."
Second, however, drinkers do not always follow a fixed path from abuse to dependence. Some remain abusers all their lives. And others cross the line to dependence soon after their first drink.
Finally, it's not the amount of alcohol consumed that defines the difference between abuse and dependence. Instead, says Rice, "we measure the problem by the impact of drinking on somebody's life. The real question is: What's your level of impairment and distress?"
Alcohol abusers may be more episodic in their problems, but they pose the same grave danger to themselves as well as the general public. If they're involved in an alcohol-related accident, they may be court ordered to undergo a addiction assessment or attend substance abuse education classes. If they seek addiction treatment, notes Rice, they generally find their way into an outpatient program.

This may contrast with people who are dependent on alcohol, or those who cannot drink safely at all. The depth of their drinking problem may call for intensive inpatient treatment--a residential program that removes them from the people, places and things associated with their alcohol use.
Look at:  https://www.hazelden.org/web/public/has50221.page


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## Cavalier40 (Apr 3, 2018)

DSM V defines sustained remission as any period longer than 12 months. It does not put a cap on remission. It does stipulate that criterion A4 (Craving or strong desire or urge to use alcohol) can still be met while in remission, and even if after 30 years, if that criterion is there, and is documented, I would code it.


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## erjones147 (Apr 6, 2018)

Also, ICD-10 does not make distinction between "early remission" and "sustained remission." Either statement would trigger the remission codes


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## aasuncion904 (Mar 23, 2019)

if "ALCOHOL IN REMISSION" is documented in the patient active list, would we be able to capture it from there?


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