ICD-10 Coding for Benzodiazepine Abuse(F13.10, F13.121)
Complete ICD-10-CM coding and documentation guide for Benzodiazepine Abuse. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Benzodiazepine Abuse
F13.1-F13.9Primary Range
Sedative, hypnotic, or anxiolytic-related disorders
This range includes codes for abuse, dependence, and unspecified use of sedatives, hypnotics, or anxiolytics.
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 there is documented abuse of benzodiazepines without dependence. |
|
| F13.121 | Sedative, hypnotic, or anxiolytic abuse with intoxication delirium | Use when abuse leads to delirium. |
|
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 abuse
Essential facts and insights about Benzodiazepine Abuse
Primary ICD-10-CM Codes for benzodiazepine abuse
Decision Criteria
clinical Criteria
- Patient exhibits compulsive use despite adverse effects.
Applicable To
- Benzodiazepine abuse
Excludes
- Sedative, hypnotic, or anxiolytic dependence (F13.20-)
Clinical Validation Requirements
- Documented compulsive use despite negative consequences
- Positive urine toxicology for benzodiazepines
Code-Specific Risks
- Confusion with long-term prescribed use
Coding Notes
- Ensure documentation specifies the substance and pattern of abuse.
F13.121 - Sedative, hypnotic, or anxiolytic abuse with intoxication delirium
Use when abuse leads to delirium.
Applicable To
- Benzodiazepine abuse with delirium
Excludes
- Sedative, hypnotic, or anxiolytic dependence with intoxication delirium (F13.221)
Clinical Validation Requirements
- Documented delirium following benzodiazepine use
- Positive toxicology screen
Coding Notes
Delirium must be clearly linked to benzodiazepine use.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Sedative, hypnotic, or anxiolytic withdrawal, uncomplicated
F13.930Differential 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 Benzodiazepine Abuse to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code F13.10.
Impact
Clinical: Impacts treatment decisions, Regulatory: Non-compliance with coding guidelines, Financial: Potential for denied claims
Mitigation Strategy
Always specify the benzodiazepine involved, Link symptoms directly to substance use
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Misclassification can result in compliance issues., Data Quality: Affects the accuracy of patient records.
Mitigation Strategy
Use F13.10 for abuse and Z79.899 for long-term prescribed use.
Impact
Failure to document specific benzodiazepine can lead to audit findings.
Mitigation Strategy
Implement checklist for documenting substance specifics.
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 Benzodiazepine Abuse, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Benzodiazepine Abuse
Use these documentation templates to ensure complete and accurate documentation for Benzodiazepine Abuse. These templates include all required elements for proper coding and billing.
Emergency Department Visit for Benzodiazepine Abuse
Specialty: Emergency MedicineRequired Elements
- Substance name
- Pattern of use
- Severity
- Withdrawal symptoms
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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