What ICD-10 Code is for Opioid Abuse

All About ICD-10 Codes for Opioid Abuse

When medical professionals diagnose individuals with an opioid use disorder (OUD), the term is rather broad, and it may not be specific enough to determine the proper treatment. This is where ICD-10 codes come in. These are medical codes published by the World Health Organization (WHO) that help standardize the documentation of diseases and disorders. Each disorder is assigned a number to help medical professionals correctly treat it and track it. 

What Is the ICD-10 Code for Opioid Abuse?

The ICD-10 code for opioid abuse is F11.10; it describes the diagnosis as “opioid abuse, uncomplicated.” The F11 refers to the larger umbrella of an opioid use disorder, and the 10 after the decimal point means the abuse is “uncomplicated,” that is, there are no other conditions that “complicate” this medical diagnosis. F11 also includes opioid dependence (F11.20 – F11.29) and opioid use (F11.90 – F11.99).

Additional Opioid Abuse Codes

Opioid abuse is an umbrella term for many specific opioid abuse disorders. Here are some that fall under the same opioid abuse category.

F11.11 – Opioid Abuse, in Remission

The F11.11 medical code is used to describe individuals who have an opioid use disorder. The individual’s history shows an addiction to opioids, but they are abstaining and have succeeded at doing so for some time.

F11.120 – Opioid Abuse with Intoxication, Uncomplicated

The F11.120 describes individuals who have an opioid use disorder and are currently intoxicated on opioids. They may exhibit symptoms such as drowsiness and slurred speech. The term “uncomplicated” means that their intoxication is due to their opioid abuse with no co-occurring medical conditions such as a psychiatric disorder.

F11.121 – Opioid Abuse With Intoxication Delirium

The F11.121 diagnosis refers to an individual who has an opioid use disorder, is intoxicated as a result of opioids, and is suffering from symptoms of delirium. These symptoms may manifest as impaired cognitive function, delusions, or extreme confusion.

F11.122 – Opioid Abuse With Intoxication With Perceptual Disturbance

The F11.122 medical code describes individuals who have an opioid use disorder, are currently intoxicated on opioids, and are suffering from perceptual disturbance. Symptoms of perceptual disturbances may include audio and visual disturbances such as a heightened awareness of color and sound or hallucinations. 

F11.129 – Opioid Abuse with Intoxication, Unspecified

The F11.129 diagnosis refers to individuals who have an opioid use disorder and are intoxicated. “Unspecified” means that the intoxication may be solely as a result of opioids, or there may be other complications. As a result, further diagnosis is needed. 

F11.14 – Opioid Abuse With Opioid-induced Mood Disorder

The F11.14 medical code is used for individuals who have an opioid use disorder and suffer from a mood disorder as a result of their opioid use. This could be depression, anxiety, mania, or something else. 

F11.150 – Opioid Abuse With Opioid-induced Psychotic Disorder With Delusions

The F11.150 diagnosis refers to individuals who have an opioid use disorder, suffer from a psychotic disorder due to their opioids, and are experiencing delusions. These delusions may be visual, such as seeing bugs on their skin; auditory, such as hearing voices; or paranoia, which means thinking that people are out to get them.

F11.151 – Opioid Abuse With Opioid-induced Psychotic Disorder With Hallucinations

The F11.151 medical code refers to individuals who have an opioid use disorder and a psychotic disorder as a result of abusing opioids. They are also suffering from hallucinations, such as hearing or seeing things that are not real. This condition is similar to F11.150 above, where the individual suffers from delusions. 

F11.159 – Opioid Abuse With Opioid-induced Psychotic Disorder, Unspecified

The F11.159 diagnosis refers to those with an opioid use disorder who are suffering from a psychotic disorder as a result of abusing opioids. Although the psychotic disorder is caused by opioids, healthcare professionals cannot specify the symptoms, making it an “unspecified” disorder.

F11.181 – Opioid Abuse With Opioid-induced Sexual Dysfunction

The F11.181 diagnosis refers to those suffering from an opioid use disorder who are now experiencing sexual dysfunction as a result of opioids. Symptoms may be erectile dysfunction or little to no sexual desire.

F11.182 – Opioid Abuse With Opioid-induced Sleep Disorder

The F11.182 medical code refers to individuals who have an opioid use disorder and are suffering from a sleep disorder as a result. Symptoms may include insomnia, waking up throughout the night, or hypersomnia. 

F11.188 – Opioid Abuse With Other Opioid-induced Disorder

The F11.188 medical code refers to individuals who have an opioid use disorder and are exhibiting symptoms of a disorder as a result of the opioids. However, the “other” designation means the disorder does not have specific symptoms to correctly categorize it. 

F11.19 – Opioid Abuse With Unspecified Opioid-induced Disorder

Similar to the F11.188, the F11.19 indicates an individual who has an opioid use disorder and is exhibiting symptoms of a disorder as a result of opioid abuse. However, the specifics of the disorder are unclear and need further diagnosis.

What Is Opioid Use Disorder, and What Are Its Symptoms?

Opioid use disorder is characterized by chronic use and abuse of opioid drugs. The drugs in question may be illegal, such as heroin, or they may be prescription medications, such as Vicodin. 

People develop an opioid addiction for various reasons. Some may go searching for drugs on the street while others may develop an “accidental” addiction. Doctors often prescribe opioid medications to help relieve pain. However, because these drugs produce feelings of euphoria and relaxation, they can be addictive. There are various signs that indicate you have an addiction to opioids.

Intense Cravings

If you have intense cravings for opioids, you may be suffering from an addiction. Intense cravings may lead you to try to get the drug at any cost. It may also cause you to dig into your savings to find ways to pay for the drug.

Higher Tolerance

As you take more opioids, your body will develop a tolerance. This means you will need more of the drug to feel the same effects. This increasing tolerance can gradually become an addiction. 

Withdrawal Symptoms

If you discontinue the drug and suffer from withdrawal symptoms, it is often a clear sign of addiction. Withdrawal symptoms will typically differ, depending on the drug. However, you may experience muscle pain, anxiety, nausea, insomnia, and more. 

Being Unable to Quit

If you have an opioid use disorder, you may find it extremely difficult, or even impossible, to quit. Remember that if you are trying to quit it’s crucial that you do so under the watch of medical professionals. Quitting on your own can be dangerous.

Strained Relationships

As your opioid addiction starts to dominate your life, you may notice that your personal and professional relationships are starting to fray. Eventually, you may begin hiding your addiction from family and friends. Or, you may lose your job as a result. This could be due to arriving late, missing too many days, or even showing up under the influence of drugs.

What Are the Treatment Options for Those With Opioid Use Disorder?

Because opioid use disorder can be a multilayered disorder with co-occurring issues, treatment plans can vary. However, the most effective treatment methods typically combine different approaches, such as medical and behavioral. Here are some effective treatment options for those suffering from opioid use disorder.

Talk Therapy

Behavioral therapies, also known as talk therapies, can be especially effective when treating F11 opioid use disorders. Therapists are able to build skills in patients to prevent relapse as well as address underlying psychological and emotional traumas that may be contributing to their addiction.

Cognitive behavioral therapy (CBT) is a common talk therapy used by therapists to change negative thought patterns. Individuals are encouraged to develop positive thought patterns in order to make positive changes in their lives. 

Motivational interviewing (MI) is another form of talk therapy that focuses on empowering individuals to change their lives. Therapists listen, act compassionately, and remain nonjudgmental while motivating individuals to abstain from opioids.

Medication-assisted Treatment (MAT)

Many individuals recovering from opioid use disorder benefit from medications that can help reduce their cravings and withdrawal symptoms. 

Some medications used are: 

  • Methadone
  • Naltrexone
  • Buprenorphine

Inpatient Treatment

For those with severe opioid use disorders, inpatient or residential treatment is highly recommended. Inpatient treatment provides a structured environment that separates individuals from their regular surroundings. They live with other recovering addicts in an environment that is supervised 24/7.

Outpatient Treatment

Outpatient treatment programs allow clients to live at home and continue with their school or work activities. However, there are regular one-on-one counseling sessions, meetings, and support groups. These programs are ideal for those who don’t need to be supervised 24/7.

Support Groups

Support groups, such as Narcotics Anonymous (NA), provide a community for those seeking others with similar experiences. There are also opportunities to be guided by a sponsor, a veteran NA member who can offer advice and support to new members.

Why Are ICD-10 Codes Necessary When Treating Clients With Opioid Abuse?

Treating each individual requires customized treatments as there are various factors that contribute to each person’s addictions. For this reason, ICD-10 medical codes are critical.

Uniform System

One reason that ICD-10 codes are critical is they provide a standardized method to track, update, and diagnose disorders, such as opioid abuse. When medical professionals begin to see razor-thin differences, such as between F11.150, opioid abuse with delusions, and F11.151, opioid abuse with hallucinations, medical professionals must have an accurate system to not only differentiate the two disorders — from recovery to remission — but also to treat the two disorders. 

Billing Purposes

Insurance companies use ICD-10 medical codes to reimburse healthcare providers for specific services administered to individuals. These codes ensure that the treatment has been identified correctly and is appropriate for the individual’s disorder.

Research

In order for healthcare professionals to research the varying opioid abuse disorders, they must have a well-documented system. This allows them to provide the proper care and accurately track updates, outcomes, and trends. Healthcare providers can also track areas that need improvement whether it’s via medication, education, or behavioral therapies.

Resources Can Be Properly Allocated

ICD-10 medical codes indicate where opioid use disorders are prevalent. Healthcare organizations can then allocate resources to areas where they are needed the most, such as rehab centers and medications.

Customized Treatment Plans

The ICD-10 codes make it easier for medical professionals to customize treatment plans that fit a person’s needs. An individual diagnosed with an F11.182 disorder will require very different treatment from someone diagnosed with an F11.121 disorder, for example. 

AutoNotes

When taking notes starts to detract from your time spent on patient care, turn to AutoNotes. This is a behavioral health AI progress notes tool that can help you generate detailed notes of your patient’s treatment evolution. Simply summarize your session with text or the tool’s dictation feature, and AutoNotes will generate comprehensive clinical notes in just a few clicks. You can even customize your PDF by adding a logo and clinician information.

Treating a patient with an opioid use disorder requires a lot of documentation. There are updates after each treatment session, notes on medications, and descriptive notes detailing progress. With AutoNotes, you can choose from various note formats such as SOAP, DAP, BIRP, and GIRP. The tool also lets you include a Mental Status Exam (MSE).

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