Table 4ICD-9-CM and ICD-10-CM diagnosis codes defining opioid use disorder (OUD)Diagnosis codeDescriptionICD-9-CM diagnosis codesF11.229Opioid dependence with intoxication, unspecifiedF11.23Opioid dependence with withdrawalF11.24Opioid dependence with opioid-induced mood disorder138 more rows
Opioid dependence, uncomplicated F11. 20 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
The three most frequently used ICD-10-CM codes were for uncomplicated opioid dependence (F1120), opioid dependence with withdrawal (F1123), and opioid use unspecified and uncomplicated (F1190).
If the encounter is for pain control or pain management, assign the category 338 code followed by the specific site of pain. For example, an encounter for pain management for acute neck pain from trauma would be coded to 338.11 and 723.1.
Opioid abuse with intoxication, unspecified F11. 129 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM F11. 129 became effective on October 1, 2021.
Substance use disorders and ICD-10-CM codingSpecifiers for Substance CodingCode1Use, unspecified.9With intoxication.92…uncomplicated.920…delirium.92164 more rows•Sep 10, 2015
89.29 or the diagnosis term “chronic pain syndrome” to utilize ICD-10 code G89. 4.
Hydrocodone is the most frequently prescribed opioid in the United States with more than 136.7 million prescriptions for hydrocodone-containing products dispensed in 2013 along with 93.7 million dispensed in 2016 and 83.6 million sold to patients in 2017 (IQVIA™ formerly known as IMS Health™).
“Opioids” include prescription drugs such as codeine, morphine, oxycodone (OxyContin®, Percodan®, Percocet®), hydrocodone (Vicodin®, Lortab®, Lorcet®), and meperidine (Demerol®), as well as illegal drugs like heroin.
ICD-10-PCS GZ3ZZZZ is a specific/billable code that can be used to indicate a procedure.
b. Many of the guidelines focus on when to use multiple codes and the inevitable question of sequencing. The general rule is that you should sequence the G89. - pain code first when the reason for the admission or encounter is pain control or pain management.
The ICD-10-CM Index indicates that pain NOS is reported with code R52 (Pain, unspecified).
A code also note instructs that 2 codes may be required to fully describe a condition but the sequencing of the two codes is discretionary, depending on the severity of the conditions and the reason for the encounter.
Clinical Information. (fer-e-sis) a procedure in which blood is collected, part of the blood such as platelets or white blood cells is taken out, and the rest of the blood is returned to the donor.
Z79.02 Long term (current) use of antithrombotics/an... Z79.1 Long term (current) use of non-steroidal anti... Z79.2 Long term (current) use of antibiotics. Z79.3 Long term (current) use of hormonal contracep... Z79.4 Long term (current) use of insulin.
The 2022 edition of ICD-10-CM Z51.81 became effective on October 1, 2021.
Use secondary code (s) from Chapter 20, External causes of morbidity, to indicate cause of injury. Codes within the T section that include the external cause do not require an additional external cause code.
T40- Poisoning by , adverse effect of and underdosing of narcotics and psychodysleptics [hallucinogens]
The 2022 edition of ICD-10-CM T40.2X1A became effective on October 1, 2021.
The ICD-10-CM Official Guidelines for Coding and Reporting provide extensive notes and instruction for coding pain (category G89). Review these guidelines in full. The following summary identifies key points.#N#When seeking a pain diagnosis, identify as precisely as possible the pain’s location and/or source. If pain is the primary symptom and you know the location, the Alphabetic Index generally will provide all the information you need.#N#Only report pain diagnosis codes from the G89 category as the primary diagnosis when: 1 The acute or chronic pain and neoplasm pain provide more detail when used with codes from other categories; or 2 The reason for the service is for pain control or pain management.
Acute pain is sudden and sharp. It can range from mild to severe and may last a few minutes or a few months. Acute pain typically does not last longer than six months and usually disappears when the physician identifies and treats the underlying cause or condition. Chronic pain may last for months or years, and may persist even after the underlying injury has healed or the underlying condition has been treated. There is no specific timeframe identifying when you can define the pain as chronic. Determine the code assignment based on provider documentation.
Do not report codes from category G89 as the first-listed diagnosis if you know the underlying (definitive) diagnosis and the reason for the service is to manage/treat the underlying condition. You may report the acute/chronic pain code (G89) as a secondary diagnosis if the diagnosis provides additional, relevant information not adequately explained by the primary diagnosis code.
Tolerance for opioids. Withdrawal symptoms when opioids are not taken. In ICD-10-CM, opioid use, abuse, and dependence are coded to category F11.
Per the Diagnostic and Statistical Manual of Mental Disorders (DSM–5): The diagnosis of Opioid Use Disorder can be applied to someone who has a problematic pattern of opioid use leading to clinically significant impairment or distress, ...
Failing to carry out important roles at home, work or school because of opioid use. Continuing to use opioids, despite use of the drug causing relationship or social problems. Giving up or reducing other activities because of opioid use. Using opioids even when it is physically unsafe.
Because provider documentation is not always detailed enough to support proper code assignment, a query may be needed when coding opioid use disorders, to attain any missing pertinent information.
Opioid abuse, addiction, and overdoses are a serious public health problem. According to the National Institute on Drug Abuse, more than 115 people in the United States die after overdosing on opioids, every day.
Taking more opioid drugs than intended. Wanting or trying to control opioid drug use without success. Spending a lot of time obtaining, taking, or recovering from the effects of opioid drugs. Cravings opioids. Failing to carry out important roles at home, work or school because of opioid use.
The Centers for Disease Control and Prevention estimates that the “economic burden” of prescription opioid misuse (including the costs of healthcare, lost productivity, addiction treatment, and criminal justice involvement) in the United States equals $78.5 billion a year. Opioid use, opioid abuse, and opioid dependence are grouped together as ...