PracticeUpdate | September 10, 2015

Substance use disorders and ICD-10-CM coding

Follow these steps to help you select the appropriate ICD-10-CM diagnostic code related to substance use disorders.

By Practice Research and Policy staff

While ICD-10-CM overall does not contain considerably more codes related to mental and behavioral disorders than found in ICD-9-CM, the section on substance use disorders is substantially larger and more detailed in ICD-10-CM. Effective Oct. 1, 2015, when ICD-10-CM diagnostic coding becomes mandatory, psychologists who assess or treat individuals with substance use disorders will be expected to indicate through their choice of diagnostic codes the substance involved and the degree of the problem. 

Substance use codes in ICD-10-CM follow the format F1x.xxx. The letter F indicates that the code is from Chapter 5: Mental, Behavioral and Neurodevelopmental Disorders, of ICD-10-CM and the numeral 1 indicates a mental or behavioral disorder due to psychoactive substance use. The next digit, indicated by the first x, signifies the problematic substance (as shown in the table in Step 1 below). All digits after the decimal point add further specificity by indicating the nature and severity of the problem (see table in Step 2 below). For instance, F10.121 is the code for "Alcohol abuse with intoxication delirium." Importantly, not all specifiers are used with every substance (particularly perceptual disturbance), so users will want to refer to the complete ICD-10-CM code set.

To download the ICD-10-CM, visit the Centers for Disease Control and Prevention website and go to "FY 2016 release of ICD-10-CM" section. Select ICD-10-CM PDF format to access a PDF version of the document. It directs you to an index of compressed zip files. Within that index, select ICD10CM_FY2016_Full_PDF.ZIP. This zip folder contains five files. Open the final file labeled 'Tabular.' 

Steps for identifying the correct ICD-10-CM code related to substance use disorders

1. Identify the substance involved.

Mental and Behavioral Disorders due to... 

Code1

...use of alcohol
F10
...use of opioidsF11
...use of cannabisF12
...use of sedatives, hypnotics, anxiolyticsF13
...use of cocaineF14
...use of other stimulants, including caffeineF15
...use of hallucinogensF16
...use of nicotineF17
...use of inhalantsF18
…use of other psychoactive substances and multiple drug useF19

1This information is made available free to the public by the Centers for Disease Control and Prevention and can be accessed online.

2. Identify the correct specifiers and add the appropriate code extension.

Specifiers for Substance Coding 

Code1

Abuse
.1
Uncomplicated.10
With intoxication.12

 ...uncomplicated

.120

 ...delirium

.121

 ...with perceptual disturbance

.122

 ...unspecified

.129
With [insert substance] - induced mood disorder.14
With [insert substance] - induced psychotic disorder.15

 ...with delusions

.150

 ...with hallucinations

.151

 ...unspecified

.159
With other [insert substance] - induced disorder.18

 ...anxiety disorder 

.180

 ...sexual disorder 

.181

 ...sleep disorder 

.182
 ...other [same-substance] - induced disorder .188
With unspecified [insert substance] - induced disorder.19
Dependence
.22
Uncomplicated.20
In remission.21
With intoxication.22

…uncomplicated

.220

…delirium

.221

…with perceptual disturbance

.222

…unspecified

.229
With withdrawal.23

…uncomplicated

.230

…delirium

.231

…with perceptual disturbance

.232

…unspecified

.239
With [insert substance] – induced mood disorder.24
With [insert substance] – induced psychotic disorder.25

…with delusions

.250

…with hallucinations

.251

…unspecified

.259
With [insert substance] – induced persisting amnestic disorder.26
With [insert substance] – induced persisting dementia.27
With other [insert substance] – induced disorders.28

…anxiety disorder

.280

…sexual dysfunction

.281

…sleep disorder

.282

…other [same-substance] - induced disorder

.288
With unspecified [insert substance] - induced disorder.29
Use, unspecified
.9
With intoxication.92

…uncomplicated

.920

…delirium

.921

…with perceptual disturbance

.922

…unspecified

.929
With withdrawal.93

…uncomplicated

.930

…delirium

.931

…with perceptual disturbance

.932

…unspecified

.939
With [insert substance] – induced mood disorder.94
With [insert substance] – induced psychotic disorder.95

…with delusions

.950

…with hallucinations

.951

 ...sleep disorder 

.959
With [insert substance] – induced persisting amnestic disorder.96
With [insert substance] – induced persisting dementia.97
With other [inset substance] – induced disorders.98

…anxiety disorder

.980

…sexual dysfunction

.981

…sleep disorder

.982

…other [same-substance] - induced disorder

.988
With unspecified [insert substance] – induced disorder.99

1This information is made available free to the public by the Centers for Disease Control and Prevention and can be accessed online.
2These specifiers differ for nicotine dependence. See full code set.