The International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) is a crucial system for coding diagnoses and procedures in healthcare. For professionals in medical billing, coding, and automotive injury repair who may encounter cases related to substance dependence, understanding specific diagnosis codes is essential. This article focuses on Diagnosis Code For Opioid Dependence, specifically ICD-10-CM code F11.20, to provide a comprehensive overview for accurate documentation and understanding.
ICD-10-CM Code F11.20: Opioid Dependence, Uncomplicated
F11.20 is a billable and specific code within the ICD-10-CM system. This means it is a valid code for medical billing and accurately represents a specific diagnosis. The code F11.20 became effective on October 1, 2015, with the introduction of ICD-10-CM, and remains current through the 2025 edition effective October 1, 2024. It’s important to note that F11.20 is the American version of the code; international versions of ICD-10 F11.20 may have variations.
Applicable Diagnoses for F11.20
The code F11.20, Opioid dependence, uncomplicated, is applicable when diagnosing:
- Opioid use disorder, moderate: This indicates a problematic pattern of opioid use leading to clinically significant impairment or distress, with a moderate level of severity.
- Opioid use disorder, severe: This signifies a more intense form of opioid use disorder with a higher degree of impairment and distress.
Understanding Annotation Back-References
In the context of ICD-10-CM, annotation back-references are crucial for comprehensive coding. Codes above F11.20 may contain annotations such as:
- Applicable To annotations
- Code Also annotations
- Code First annotations
- Excludes1 annotations
- Excludes2 annotations
- Includes annotations
- Note annotations
- Use Additional annotations
These annotations provide further guidance and context when using F11.20 and related codes, ensuring accurate and detailed diagnostic coding.
Approximate Synonyms for F11.20
To further clarify the scope of F11.20, here are approximate synonyms that are clinically related:
- Combined opioid and other drug dependence (continuous & episodic)
- Combined opioid with other drug dependence (continuous & episodic)
- Continuous opioid dependence
- Drug dependence, combined, opioid and other drug
- Episodic opioid dependence
- Fentanyl dependence
- Heroin dependence
- Long term methadone therapy for drug abuse / Long-term current use of methadone for drug abuse
- Opioid dependence (moderate use disorder)
- Opioid dependence (severe use disorder)
- Opioid dependence, continuous & episodic
- Opioid dependence, moderate use
- Opioid dependence, on agonist therapy
- Opioid dependence, severe use
These synonyms highlight the various clinical presentations that may fall under the diagnosis code for opioid dependence F11.20.
Diagnostic Related Groups (DRG) and Code History
ICD-10-CM F11.20 is grouped within Diagnostic Related Group(s) (MS-DRG v42.0), which is relevant for hospital reimbursement and statistical analysis.
The code history of F11.20 shows its stability within the ICD-10-CM system:
- 2016: New code (first year of non-draft ICD-10-CM)
- 2017-2025: No change
This consistent history indicates the established and reliable nature of F11.20 in diagnostic coding.
ICD-10-CM Codes Adjacent to F11.20
Understanding the codes adjacent to F11.20 provides further context within the ICD-10-CM hierarchy. Examples include codes related to opioid abuse and dependence with various complications:
- F11.15 Opioid abuse with opioid-induced psychotic disorder
- F11.2 Opioid dependence (parent category)
- F11.21 Opioid dependence in remission
- F11.22 Opioid dependence with intoxication
- F11.23 Opioid dependence with withdrawal
- F11.25 Opioid dependence with opioid-induced psychotic disorder
Conclusion
ICD-10-CM diagnosis code F11.20 is a vital tool for accurately classifying and coding uncomplicated opioid dependence, encompassing moderate to severe opioid use disorders. For healthcare professionals and related fields, a thorough understanding of F11.20, its applicable diagnoses, synonyms, and context within the ICD-10-CM system is crucial for precise documentation, billing, and data analysis related to diagnosis code for opioid dependence.
