Understanding ICD-10 Code F13.10: Sedative, Hypnotic, or Anxiolytic Abuse
The International Classification of Diseases (ICD) is a system that was developed to help with consistency in data related to various diseases. This global system provides uniformity when recording data to track disease trends. The ICD-10 code F13.10 is for sedative, hypnotic, or anxiolytic abuse and its subcategories.
Understanding the ICD-10 F13 Code Category
ICD codes are updated twice a year to reflect new information that comes to light as a result of research findings. With each update, codes are dropped, added, and refined. For practical purposes, many insurance companies do not update their systems every six months. Instead, they only make major updates when it becomes necessary. As a practitioner or billing specialist, it is important to make sure you are using the same version of ICD-10 codes.
Section F13 of ICD-10 is for the treatment of sedative, hypnotic, or anxiolytic drugs. The first code is F13.10, which stands for uncomplicated abuse of these substances, but abuse of these substances rarely stands alone. It is often accompanied by other conditions and abuse of other categories of substances.
Category F13 contains 41 subcategories, all of which are related to other conditions that can be caused by or accompany the abuse of sedative, hypnotic, or anxiolytic drugs. This category is divided according to other disorders that can occur in conjunction with the primary diagnosis of sedative, hypnotic, or anxiolytic substance abuse. Here are a few of the more notable broad categories and codes within this category.
F13.1 Sedative, Hypnotic, or Anxiolytic-Related Abuse
The first three subcategories in this code are:
- F13.10 Sedative, hypnotic, or anxiolytic abuse, uncomplicated
- F13.11 Sedative, hypnotic, or anxiolytic abuse, in remission
- F13.12 Sedative, hypnotic, or anxiolytic abuse with intoxication
As already stated, this category of substance abuse is seldom uncomplicated, as it can cause or exacerbate a myriad of other pre-existing or co-existing conditions. F13.11 would be used for someone who needs ongoing support to remain substance-free.
F13.12 typically applies to someone who arrived at a treatment facility or emergency room while under the influence of these drugs. This category is further divided into uncomplicated (F13.120), delirium (F13.121), and unspecified (F13.129). Only one of these subcategories references a specific symptom of substance intoxication.
F13.13 Sedative, Hypnotic, or Anxiolytic Abuse With Withdrawal
Substance withdrawal presents its own set of complications and symptoms. These can include:
- Postural hypotension
- Lack of coordination
- Blurred vision
It might be noted that only delirium and perceptual disturbances have a separate ICD-10 code.
F13.14 and F13.15 Mood and Psychotic Disorders
Sedative, hypnotic, or anxiolytic abuse can present themselves as a mood or psychotic disorder. In this case, the criteria from DSM-5 are used to classify the mood or psychotic disorder. Even though these disorders can be present without substance abuse, F13.14 and F13.15 are only for when these conditions are related to the substance abuse rather than when they are present without it. Another thing to note is that the causal connection between mood and psychotic disorder can evolve as treatment progresses, resulting in a change in the ICD-10 code.
F13.18 Sedative, Hypnotic, or Anxiolytic Abuse With Other Sedative, Hypnotic, or Anxiolytic-Induced Disorders
Sedative, hypnotic, or anxiolytic abuse can induce a range of other disorders that were not present before the substance abuse began. In many cases, they will disappear on their own when the abuse is no longer an issue, or they might need ongoing treatment after the initial abuse is in remission. These codes for substance-induced disorders include anxiety (F13.180), sexual dysfunction (F13.181), sleep disorder (F13.182), and any other disorder (F13.188). F13.19 is for an unspecified disorder.
F13.2 Sedative, Hypnotic, or Anxiolytic-Related Dependence
The ICD-10 differentiates between the terms “abuse” and “dependence.” Abuse means using the substance in a way that is potentially harmful to their health, but it does not mean that they are necessarily dependent on the substance. An example of this would be a person who arrived at a healthcare center intoxicated on the substance, but it was their first time using it inappropriately.
Dependence means that a person has a psychological or physical need for the substance, and if they do not get it, then they will experience withdrawal symptoms. One of the most important considerations in this ICD-10 category is to determine if the incident is acute or connected to drug dependence.
ICD-10 F13 codes for dependence mirror those for acute substance use. These include F13.20, F13.21, and F13.22 for uncomplicated dependence, dependence in remission, and intoxication. As with acute F13 codes, the codes for intoxication include uncomplicated (F13.220), delirium (F13.221), and unspecified (F13.229). It also has a category for withdrawal (F13.23) that includes uncomplicated (F13.230), delirium (F13.231), with perceptual disturbance (F13.232), and unspecified (F13.239).
The F13 codes have a section for sedative, hypnotic, or anxiolytic-induced mood disorder (F13.24) and psychotic disorder (F13.25). Psychotic disorder is also divided into that with delusions (F13.250), with hallucinations (F13.251), and unspecified (F13.259). Although this section mimics those categories included earlier, it is important to note that these conditions are related to dependence rather than simple abuse. The most important factor in correct coding is to determine if the presenting client is dependent on the substance.
F13.26–F13.99 Sedative, Hypnotic, or Anxiolytic-induced Disorders
Sedative, hypnotic, or anxiolytic dependence causes brain changes that can lead to the development of a range of disorders other than mood or psychotic disorders. These include sedative, hypnotic, or anxiolytic dependence-induced:
- F13.26 – Amnestic disorder
- F13.27 – Persisting dementia
- F13.280 – Anxiety disorder
- F13.281 – Sexual dysfunction
- F13.282 – Sleep disorder
- F13.288 – Sedative, hypnotic, or anxiolytic dependence-induced disorder
- F13.29 – Unspecified sedative, hypnotic, or anxiolytic dependence-induced disorder
F13.9–F13.99 Sedative, Hypnotic, or Anxiolytic Use Disorders
Even when used as directed by a physician, the use of sedative, hypnotic, or anxiolytic substances can lead to intoxication, withdrawal, and the development of other psychological disorders. Use is considered less severe than abuse or dependence. When assigning a code, when both use and abuse are documented, it is generally accepted practice to choose the more severe of the codes. This is also the case if both abuse and dependence or all three are documented. In this case, you would use the codes for dependence.
The codes for F13.9 include:
- F13.90 Sedative, hypnotic, or anxiolytic use, unspecified, uncomplicated
- F13.91 Sedative, hypnotic, or anxiolytic use, unspecified, in remission
- F13.92 Sedative, hypnotic, or anxiolytic use, unspecified with intoxication
Once again, codes exist for uncomplicated intoxication (F13.920), delirium (F13.921), and unspecified (F13.929). F13.93 is for use withdrawal and its related conditions. These include uncomplicated (F13.930, delirium (F13.931), with perceptual disturbances (F13.932), and unspecified (F13.939).
Use disorders also include those with a mood disorder (13.94) or psychotic disorder (F13.95). In addition, use-related psychotic disorders include that which occurs with delusions (F13.950), with hallucinations (F13.951), and unspecified (F13.959).
The remaining ICD-10 codes for sedative, hypnotic, or anxiolytic use include disorders induced by the substance. These are:
- F13.96 – Persistent amnestic disorder
- F13.97 – Persistent dementia
- F13.980 – Anxiety disorder
- F13.981 – Sexual dysfunction
- F13.982 – Sleep disorder
- F13.988 – Unspecified with other sedative, hypnotic, or anxiolytic-induced disorder
- F13.99 – Unspecified with unspecified sedative, hypnotic, or anxiolytic-induced disorder
Final Word on Sedative, Hypnotic, or Anxiolytic Substance-Related Codes
The ICD-10 codes for use, abuse, and dependence-related disorders are organized with the most severe category (dependence) in the second section. It is important to rule out dependence when deciding whether to use the abuse or use-related sections. It is not unusual for a client to have more than one or multiple ICD-10 codes in this category. When in doubt, you should consult with the DSM-V for clarification.
AutoNotes Helps with Proper ICD-10 Coding
Understanding the set of ICD-10 F13.10 codes is important for insurance billing purposes, and it is also important for clear communication with other professionals. Often, you will be working closely with other clinicians as part of the client’s care team. Proper diagnosis and coding can help improve the quality of care the person receives by allowing consistency among the various providers.
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