ICD-10 Coding for Opioid Dependence in Remission(F11.21)
Complete ICD-10-CM coding and documentation guide for Opioid Dependence in Remission. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Opioid Dependence in Remission
F11.2-F11.29Primary Range
Opioid dependence codes
This range includes codes for opioid dependence, specifying different states such as uncomplicated, in remission, and with withdrawal.
Key Information: ICD-10 code for opioid dependence in remission
Essential facts and insights about Opioid Dependence in Remission
Primary ICD-10-CM Code for opioid dependence in remission
Decision Criteria
documentation Criteria
- Provider must document 'in remission' status explicitly.
clinical Criteria
- Patient must be abstinent from non-prescribed opioids.
Applicable To
- Opioid dependence in sustained remission
- Opioid dependence in early remission
Clinical Validation Requirements
- Provider documentation explicitly stating 'in remission'
- Abstinence from non-prescribed opioids for specified duration
- Negative urine drug screens (UDS) for illicit opioids
Code-Specific Risks
- Incorrectly assuming remission based on medication use alone
- Failure to specify 'early' or 'sustained' remission
Coding Notes
- Ensure explicit documentation of remission status and duration.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Long-term (current) use of opiate analgesic
Z79.891Differential 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 Opioid Dependence in Remission to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code F11.21.
Impact
Clinical: Misrepresentation of patient's clinical status., Regulatory: Non-compliance with ICD-10 documentation standards., Financial: Potential claim denials or audits.
Mitigation Strategy
Educate providers on documentation requirements, Use templates to ensure completeness
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient records and statistics.
Mitigation Strategy
Require explicit documentation of remission status.
Impact
Lack of explicit remission documentation can lead to audit flags.
Mitigation Strategy
Ensure all remission cases are clearly documented with duration and status.
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 Opioid Dependence in Remission, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Opioid Dependence in Remission
Use these documentation templates to ensure complete and accurate documentation for Opioid Dependence in Remission. These templates include all required elements for proper coding and billing.
Patient in sustained remission on buprenorphine
Specialty: Addiction MedicineRequired Elements
- Remission status
- Duration of abstinence
- Medication details
- Negative UDS results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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