ICD-10 Coding for Benzo Use Disorder(F13.10, F13.20)
Complete ICD-10-CM coding and documentation guide for Benzo Use Disorder. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Benzo Use Disorder
F13.1-F13.9Primary Range
Mental and behavioral disorders due to use of sedatives or hypnotics
This range covers all disorders related to the use of benzodiazepines, including abuse, dependence, and withdrawal.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| F13.10 | Sedative, hypnotic or anxiolytic abuse, uncomplicated | Use when the patient exhibits mild abuse without dependence. |
|
| F13.20 | Sedative, hypnotic or anxiolytic dependence, uncomplicated | Use when the patient exhibits dependence with or without withdrawal symptoms. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for benzodiazepine use disorder
Essential facts and insights about Benzo Use Disorder
Primary ICD-10-CM Codes for benzo use disorder
Decision Criteria
clinical Criteria
- Patient meets 2-3 DSM-5 criteria for substance abuse
Applicable To
- Mild benzodiazepine abuse
Excludes
- Sedative, hypnotic or anxiolytic dependence (F13.20)
Clinical Validation Requirements
- Patient meets 2-3 DSM-5 criteria for substance abuse
Code-Specific Risks
- Misclassification if dependence criteria are met
Coding Notes
- Ensure documentation specifies abuse criteria without meeting dependence.
F13.20 - Sedative, hypnotic or anxiolytic dependence, uncomplicated
Use when the patient exhibits dependence with or without withdrawal symptoms.
Applicable To
- Moderate to severe benzodiazepine dependence
Excludes
- Sedative, hypnotic or anxiolytic abuse (F13.10)
Clinical Validation Requirements
- Patient meets 4 or more DSM-5 criteria for substance dependence
Coding Notes
Document all criteria met for dependence, including any withdrawal symptoms.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Benzo Use Disorder to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code F13.10.
Impact
Clinical: May lead to inadequate treatment planning., Regulatory: Increases risk of audit due to incomplete documentation., Financial: Potential for denied claims or reduced reimbursement.
Mitigation Strategy
Use structured templates, Regularly review documentation guidelines
Impact
Reimbursement: May result in lower reimbursement rates., Compliance: Increases risk of audit due to lack of specificity., Data Quality: Reduces accuracy of patient records.
Mitigation Strategy
Query the provider for specific criteria to use the correct code.
Impact
Using unspecified codes when specific criteria are documented.
Mitigation Strategy
Ensure all DSM-5 criteria and symptoms are documented to support specific coding.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Benzo Use Disorder, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Benzo Use Disorder
Use these documentation templates to ensure complete and accurate documentation for Benzo Use Disorder. These templates include all required elements for proper coding and billing.
Documenting Benzodiazepine Dependence
Specialty: PsychiatryRequired Elements
- Substance name and dosage
- Duration of use
- DSM-5 criteria met
- Withdrawal symptoms
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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