F11 - Opioid related disorders

Specific Coding for Opioid related disorders

Non-specific codes like F11 require more digits to indicate the appropriate level of specificity. Consider using any of the following ICD-10 codes with a higher level of specificity when coding for opioid related disorders:

Patient Education

Opioid Misuse and Addiction

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 doctor 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 doctors prescribe them for chronic pain.

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:

• The person's face is extremely pale and/or feels clammy to the touch
• Their body goes limp
• Their fingernails or lips have a purple or blue color
• They start vomiting or making gurgling noises
• They cannot be awakened or are unable to speak
• Their breathing or heartbeat slows or stops

Other risks of using prescription opioids include dependence and 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 risks of dependence and addiction are higher if you misuse the medicines. Misuse can include taking too much medicine, taking someone else's medicine, taking it in a different way than you are supposed to, or taking the medicine to get high.

Opioid misuse, addiction, and overdoses are serious public health problems in the United States. Another problem is that more women are misusing opioids during pregnancy. This can lead to babies being addicted and going through withdrawal, known as neonatal abstinence syndrome (NAS). Opioid misuse may sometimes also lead to heroin use, because some people switch from prescription opioids to heroin.

The main treatment for prescription opioid addiction is medication-assisted treatment (MAT). It includes medicines, counseling, and support from family and friends. MAT can help you stop using the drug, get through withdrawal, and cope with cravings. There is also a medicine called naloxone which can reverse the effects of an opioid overdose and prevent death, if it is given in time.

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

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

Code History

• 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 (First year ICD-10-CM implemented into the HIPAA code set)