Code Attributes
- Non-Billable/Non-Specific Code
Clinical Information
- Disorders related or resulting from abuse or mis-use of opioids.
Codes
- F11.1 Opioid abuse
- F11.10 Opioid abuse, uncomplicated
- F11.11 Opioid abuse, in remission
- F11.12 Opioid abuse with intoxication
- F11.120 Opioid abuse with intoxication, uncomplicated
- F11.121 Opioid abuse with intoxication delirium
- F11.122 Opioid abuse with intoxication with perceptual disturbance
- F11.129 Opioid abuse with intoxication, unspecified
- F11.13 Opioid abuse with withdrawal
- F11.14 Opioid abuse with opioid-induced mood disorder
- F11.15 Opioid abuse with opioid-induced psychotic disorder
- F11.150 Opioid abuse with opioid-induced psychotic disorder with delusions
- F11.151 Opioid abuse with opioid-induced psychotic disorder with hallucinations
- F11.159 Opioid abuse with opioid-induced psychotic disorder, unspecified
- F11.18 Opioid abuse with other opioid-induced disorder
- F11.181 Opioid abuse with opioid-induced sexual dysfunction
- F11.182 Opioid abuse with opioid-induced sleep disorder
- F11.188 Opioid abuse with other opioid-induced disorder
- F11.19 Opioid abuse with unspecified opioid-induced disorder
- F11.2 Opioid dependence
- F11.20 Opioid dependence, uncomplicated
- F11.21 Opioid dependence, in remission
- F11.22 Opioid dependence with intoxication
- F11.220 Opioid dependence with intoxication, uncomplicated
- F11.221 Opioid dependence with intoxication delirium
- F11.222 Opioid dependence with intoxication with perceptual disturbance
- F11.229 Opioid dependence with intoxication, unspecified
- F11.23 Opioid dependence with withdrawal
- F11.24 Opioid dependence with opioid-induced mood disorder
- F11.25 Opioid dependence with opioid-induced psychotic disorder
- F11.250 Opioid dependence with opioid-induced psychotic disorder with delusions
- F11.251 Opioid dependence with opioid-induced psychotic disorder with hallucinations
- F11.259 Opioid dependence with opioid-induced psychotic disorder, unspecified
- F11.28 Opioid dependence with other opioid-induced disorder
- F11.281 Opioid dependence with opioid-induced sexual dysfunction
- F11.282 Opioid dependence with opioid-induced sleep disorder
- F11.288 Opioid dependence with other opioid-induced disorder
- F11.29 Opioid dependence with unspecified opioid-induced disorder
- F11.9 Opioid use, unspecified
- F11.90 Opioid use, unspecified, uncomplicated
- F11.91 Opioid use, unspecified, in remission
- F11.92 Opioid use, unspecified with intoxication
- F11.920 Opioid use, unspecified with intoxication, uncomplicated
- F11.921 Opioid use, unspecified with intoxication delirium
- F11.922 Opioid use, unspecified with intoxication with perceptual disturbance
- F11.929 Opioid use, unspecified with intoxication, unspecified
- F11.93 Opioid use, unspecified with withdrawal
- F11.94 Opioid use, unspecified with opioid-induced mood disorder
- F11.95 Opioid use, unspecified with opioid-induced psychotic disorder
- F11.950 Opioid use, unspecified with opioid-induced psychotic disorder with delusions
- F11.951 Opioid use, unspecified with opioid-induced psychotic disorder with hallucinations
- F11.959 Opioid use, unspecified with opioid-induced psychotic disorder, unspecified
- F11.98 Opioid use, unspecified with other specified opioid-induced disorder
- F11.981 Opioid use, unspecified with opioid-induced sexual dysfunction
- F11.982 Opioid use, unspecified with opioid-induced sleep disorder
- F11.988 Opioid use, unspecified with other opioid-induced disorder
- F11.99 Opioid use, unspecified with unspecified opioid-induced disorder
ICD-10 code F11 is associated with opioid related disorders. This range of codes is part of the ICD-10 (International Classification of Diseases, Tenth Revision) system, which is used globally to classify and code all diagnoses, symptoms, and procedures recorded in conjunction with hospital care, including the mental health sector.
Here's more about using ICD-10 code F11:
1. F11 code categories
The F11 code has several subcategories that specify the nature of the opioid-related disorder, ranging from acute intoxication (F11.0) to withdrawal (F11.3), dependence (F11.2), and others. Each subcategory has its additional digit (e.g., F11.22 for opioid dependence with intoxication) to provide further detail on the condition being treated. Selecting the most accurate subcategory is essential for clear communication with insurance companies and for ensuring proper treatment documentation.
2. Billing and insurance claims
When billing for services related to opioid-related disorders, accurately coding the diagnosis with the specific F11 subcategory is key. This ensures that insurance claims are processed smoothly and reduces the likelihood of claim denials due to coding errors. Before submitting a claim, verify that the specific F11 code used aligns with the treatment provided and that it is accepted by the client's insurance plan.
3. Documentation and compliance
Make sure you're backing up that F11 diagnosis with solid notes in your client's file. Jot down specific details about their condition, how you're planning to treat it, and keep track of their progress, especially focusing on the aspects covered by whichever F11 subcategory you've selected. Good record-keeping is essential for providing quality care and keeping yourself protected if you ever face an audit.
4. Communication with insurers
Should questions or disputes arise from an insurance company regarding a claim involving an F11 code, be prepared to provide detailed justification for the diagnosis code you chose. This can involve submitting additional documentation or records to support the diagnosis and the necessity of the treatment provided.
5. Staying updated
ICD-10 codes are subject to revision and updates, so it's important to stay informed about any changes to the F11 category or other codes relevant to your practice. Professional organizations, coding websites, and healthcare newsletters typically provide timely updates and resources to help practitioners stay current with coding changes that might affect your billing and documentation procedures. Joining professional forums or setting up alerts from official coding authorities can also be a practical way to ensure you don't miss important modifications to the coding system.
Sources
- "Ontology Lookup Service (OLS)". EMBL-EBI. EMBL-EBI, n.d., https://www.ebi.ac.uk/ols4/ontologies/efo/classes?short_form=EFO_0005611. Accessed 27 Jan 2025.
