ICD 10 Coding Alert

Question: What insight can you provide on how drug testing diagnoses will look under ICD-10?

Michigan Subscriber

Answer: You won't find a one-to-one crosswalk between ICD-9 and ICD-10 for drug use. ICD-9 does not provide one specific code for a urine drug test -- nor does ICD-10. The correct diagnosis code for billing a lab drug test depends on the signs, symptoms, patient condition, or other reason for the test, such as screening.

For example: The physician orders a drug screen for a patient diagnosed with Cannabis dependence who uses the drug intermittently. Report the ordering diagnosis as 304.32 (Cannabis dependence, episodic use) with ICD-9.

ICD-10 crosswalk: Although ICD-10 often provides more detail than ICD-9 -- leading to more code choices for ICD-10 -- the opposite is true in this case. The following three ICD-9 codes crosswalk to a single ICD-10 code (F12.20, Cannabis dependence, uncomplicated):

• 304.30 -- Cannabis dependence, unspecified use
• 304.31 -- Cannabis dependence, continuous use
• 304.32 -- Cannabis dependence, episodic use. Use Different Codes for Abuse or Use

Both ICD-9 and ICD-10 distinguish between drug dependence versus drug abuse. For instance, 304.3x identifies Cannabis dependence while 305.2x (Non-dependent Cannabis abuse) identifies Cannabis abuse.

Similarly, ICD-10 provides F12.20 for Cannabis dependence, and F12.10 (Cannabis abuse, uncomplicated) for Cannabis abuse.

Additionally, ICD-10 provides separate codes for drug use when the physician doesn't specify whether the use constitutes dependence or abuse. For instance, you would report Cannabis use as F12.90 (Cannabis use, unspecified, uncomplicated).