Do you know how to accurately use the F10.- to F19.- code range?
The 10th edition of the ICD-10-CM code set includes the code range F01.- (Vascular dementia) to F99 (Mental disorder, not otherwise specified) for mental and behavioral health disorders. Within this range, coders use the range F10.- (Alcohol related disorders) to F19.- (Other psychoactive substance related disorders) for behavioral health issues associated with substance abuse.
These codes are split out first by substance type, then by several specifiers, including whether a patient experiences remission, dependence, withdrawal, or intoxication. Even with thorough documentation from providers to ensure accuracy, it can be difficult to use the F10.- to F19.- code range properly, since there are so many coding options within each main code.
Familiarize yourself with the F10.- to F19.- code range to improve your coding skills for substance abuse and its effects on mental health.
Know the F10.- to F19.- Range of the ICD-10-CM
Before you can master each code-within-a-code for substance abuse and behavioral health, it is important to understand the range at a high level. The ICD-10-CM code range F10.- to F19.- includes these 10 codes:
Take These Steps to Use the F10.- to F19.- Code Range Properly
First, determine the primary specific substance involved. For example, if a patient has substance abuse issues pertaining to oxycodone, start with F11.-.
The next step is to clarify whether the patient’s use of the substance is abuse, dependence, or unspecified. Let’s stick with the example of a patient with an opioid-related disorder, and say that the most appropriate label for this hypothetical patient is dependence rather than abuse. In this case, use F11.2-.
After you select F11.2- you have the following options:
Keep in mind that you may need to use a 6th character to specify a patient’s status if they have opioid dependence with intoxication, an opioid-induced psychotic disorder, or another opioid-induced disorder. For instance, if the patient in this example has an opioid-induced psychotic disorder with hallucinations, use F11.251.
While this example follows the path of a patient with substance abuse issues pertaining to opioids, the other code sets in the F10.- to F19.- range for other substances have a similar structure. See the full list of billable codes and familiarize yourself with the code set here.
Reference These Tips for Coding Behavioral Health Issues Related to Substance Abuse
Since there is overlap between use, abuse, and dependence, it is important for coders to know the coding hierarchy for patients with more than one of these factors documented.
If the patient has both use and abuse documented in their record, code for abuse. If the patient has both use and dependence in their record, code for dependence. If the patient has both abuse and dependence in their record, code for dependence. Finally, if a patient has use, abuse, and dependence documented in their record, code for dependence. In short, always prioritize the highest severity of substance abuse documented in a patient’s record.
Keep in mind that it is not the coder’s decision to determine whether a patient with a history of substance abuse is in remission based on time frames indicated in a patient’s medical record; the only time it is acceptable to indicate that a patient’s substance abuse or dependence is in remission is if the provider shows specific documentation that the patient is in remission.
Know When to Use Additional Codes Beyond the F10.- to F19.- Range
There are a few other codes that may be relevant to patients with a history of substance abuse beyond the F10.- to F19.- code range, such as:
Use codes Z71.41 or Z71.51 for instances where the person with substance abuse issues is the counseling recipient; use Z71.42 or Z71.52 if the counseling is for one of their family members.
Use the Z81.- code set to record family history of substance abuse:
If a patient requires detoxification services related to substance abuse, use 2025 ICD-10-PCS Procedure Code HZ2ZZZZ (Detoxification Services for Substance Abuse Treatment).
Michelle Falci, BA, M Falci Communications LLC, Contributing Writer
