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Home/Diagnosis/ICD-10 Coding for Heroin Abuse

ICD-10 Coding for Heroin Abuse

F11.12
F11.20

Complete ICD-10-CM coding and documentation guide for icd-10 coding for heroin abuse includes clinical validation requirements, medical necessity guidelines, and coding policies.

Also Known as:
Heroin Use Disorder
Opioid Abuse
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Key Information: ICD-10 Coding for Heroin Abuse

Essential facts and insights about ICD-10 Coding for Heroin Abuse

Use ICD-10 code F11.12 for opioid abuse, with intoxication, ensuring proper documentation in clinical notes.

Primary ICD-10-CM Codes

Opioid abuse, with intoxication

Non-Billable
F11.12
Non-Billable

Diagnostic Criteria

  • • Presence of intoxication symptoms without dependence

Applicable To

  • • Heroin abuse with intoxication

Important Notes

  • • Ensure documentation specifies abuse with intoxication to avoid misclassification.

Opioid dependence, uncomplicated

Billable Code
F11.20
Billable

Diagnostic Criteria

  • • Documented evidence of tolerance or withdrawal
  • • Positive urinalysis for opioids

Applicable To

  • • Heroin dependence

Important Notes

  • • Ensure documentation supports dependence criteria.
Ancillary Codes

Additional codes that may be used with this diagnosis

T40.1X1

Poisoning by heroin, accidental (unintentional)

Use in cases of heroin overdose or poisoning.

Z79.891

Long term (current) use of opiate analgesic

Use for patients on maintenance therapy.

Frequently Asked Questions

What is the ICD-10 code for heroin abuse?

The ICD-10 code for heroin abuse with intoxication is F11.12, while heroin dependence is coded as F11.20.

How do you document heroin overdose?

Document heroin overdose by noting symptoms like unresponsiveness and pinpoint pupils, and treatments such as naloxone administration.

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