2024 ICD-10-CM Diagnosis Code F11.959

Opioid use, unspecified with opioid-induced psychotic disorder, unspecified

ICD-10-CM Code:
F11.959
ICD-10 Code for:
Opioid use, unsp w opioid-induced psychotic disorder, unsp
Is Billable?
Yes - Valid for Submission
Chronic Condition Indicator: [1]
Not chronic
Code Navigator:

Code Classification

  • Mental and behavioural disorders
    (F01–F99)
    • Mental and behavioral disorders due to psychoactive substance use
      (F10-F19)
      • Opioid related disorders
        (F11)

F11.959 is a billable diagnosis code used to specify a medical diagnosis of opioid use, unspecified with opioid-induced psychotic disorder, unspecified. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024.

Unspecified diagnosis codes like F11.959 are acceptable when clinical information is unknown or not available about a particular condition. Although a more specific code is preferable, unspecified codes should be used when such codes most accurately reflect what is known about a patient's condition. Specific diagnosis codes should not be used if not supported by the patient's medical record.

Approximate Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

  • Psychotic disorder caused by opioid

Clinical Classification

Clinical CategoryCCSR Category CodeInpatient Default CCSROutpatient Default CCSR
Opioid-related disordersMBD018Y - Yes, default inpatient assignment for principal diagnosis or first-listed diagnosis.Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.
Schizophrenia spectrum and other psychotic disordersMBD001N - Not default inpatient assignment for principal diagnosis or first-listed diagnosis.N - Not default outpatient assignment for principal diagnosis or first-listed diagnosis.

Index to Diseases and Injuries References

The following annotation back-references for this diagnosis code are found in the injuries and diseases index. The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10-CM code(s).

Convert F11.959 to ICD-9-CM

  • ICD-9-CM Code: 292.89 - Drug mental disorder NEC
    Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.

Patient Education


Opioids and Opioid Use Disorder (OUD)

What are opioids?

Opioids, sometimes called narcotics, are a type of drug. They include strong prescription pain relievers such as oxycodone, hydrocodone, fentanyl, and tramadol. The illegal drug heroin is also an opioid. Some opioids are made from the opium plant, and others are synthetic (man-made).

A health care provider may give you a prescription opioid to reduce pain after you have had a major injury or surgery. You may get them if you have severe pain from health conditions like cancer. Some providers prescribe them for chronic pain.

What are the side effects and risks of opioids?

Opioids can cause side effects such as drowsiness, mental fog, nausea, and constipation. They may also cause slowed breathing, which can lead to overdose deaths. If someone has signs of an overdose, call 911. These signs may include:

  • Very small pupils of the eyes
  • Falling asleep or loss of consciousness
  • Slow, shallow breathing
  • Choking or gurgling sounds
  • Vomiting
  • Limp body
  • Pale, blue, or cold skin
  • Faint heartbeat
  • Purple lips and fingernails

When using opioids, there is also a risk of opioid use disorder (OUD).

What is opioid use disorder (OUD)?

Opioid use disorder (OUD) means that you have a problematic pattern of using opioids. The pattern causes a lot of distress and impairment (meaning that it causes problems in and interferes with your daily life). Instead of OUD, sometimes people use the terms "opioid dependence" and "opioid addiction." Dependence means feeling withdrawal symptoms when not taking the drug. Addiction is a chronic brain disease that causes a person to compulsively seek out drugs, even though they cause harm.

The risk of OUD is higher if you misuse the medicines. Misuse can include taking more than your prescribed dose or taking it more often, using it to get high, or taking someone else's opioids.

Opioid use disorder and overdoses are serious public health problems in the United States. As more people misuse opioids, more women are misusing opioids during pregnancy. This can lead to health risks for the mother and baby. The baby may be born with neonatal abstinence syndrome (NAS). NAS is a group of withdrawal symptoms that a baby has after being exposed to drugs during pregnancy.

Another problem with increased opioid misuse is that it can also lead to more heroin use. There are some people who switch from prescription opioids to heroin because heroin may be cheaper and easier to get.

How are opioid use disorder (OUD) and opioid overdose treated?

There are effective medicines to treat OUD. Using medicines to treat OUD is called medications for opioid use disorder (MOUD). MOUD can help you stop using the drug, get through withdrawal, and cope with cravings. It is often combined with behavioral therapy and counseling. Having support from family and friends can also help.

There is also a medicine called naloxone which can treat opioid overdoses. It can reverse the effects of the overdose and prevent death if it is given quickly.

How can I prevent problems when taking prescription opioids?

To prevent problems with prescription opioids, be sure to follow your doctor's instructions when taking them. Do not share your medicines with anyone else. Contact your doctor if you have any concerns about taking the medicines.

NIH: National Institute on Drug Abuse


[Learn More in MedlinePlus]

Prescription Drug Misuse

If you take a medicine in a way that is different from what the doctor prescribed, it is called prescription drug misuse. It could be:

  • Taking a medicine that was prescribed for someone else
  • Taking a larger dose than you are supposed to
  • Taking the medicine in a different way than you are supposed to. This might be crushing tablets and then snorting or injecting them.
  • Using the medicine for another purpose, such as getting high

Misusing some prescription drugs can lead to addiction. These include opioids, sedatives, tranquilizers, and stimulants.

Every medicine has some risk of side effects. Doctors take this into account when prescribing medicines. People who misuse these drugs may not understand the risks. The medicines may not be safe for them, especially at higher doses or when taken with other medicines.

NIH: National Institute on Drug Abuse


[Learn More in MedlinePlus]

Psychotic Disorders

Psychotic disorders are severe mental disorders that cause abnormal thinking and perceptions. People with psychoses lose touch with reality. Two of the main symptoms are delusions and hallucinations. Delusions are false beliefs, such as thinking that someone is plotting against you or that the TV is sending you secret messages. Hallucinations are false perceptions, such as hearing, seeing, or feeling something that is not there.

Schizophrenia is one type of psychotic disorder. People with bipolar disorder may also have psychotic symptoms. Other problems that can cause psychosis include alcohol and some drugs, brain tumors, brain infections, and stroke.

Treatment depends on the cause of the psychosis. It might involve drugs to control symptoms and talk therapy. Hospitalization is an option for serious cases where a person might be dangerous to himself or others.


[Learn More in MedlinePlus]

Code History

  • FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
  • FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
  • FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
  • FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.

Footnotes

[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.