2021 ICD-10-CM Code F11.1

Opioid abuse

Version 2021

Not Valid for Submission

F11.1 is a non-specific and non-billable diagnosis code code, consider using a code with a higher level of specificity for a diagnosis of opioid abuse. The code is not specific and is NOT valid for the year 2021 for the submission of HIPAA-covered transactions. Category or Header define the heading of a category of codes that may be further subdivided by the use of 4th, 5th, 6th or 7th characters.

ICD-10:F11.1
Short Description:Opioid abuse
Long Description:Opioid abuse

Code Classification

Specific Coding for Opioid abuse

Non-specific codes like F11.1 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 abuse:

  • BILLABLE CODE - Use F11.10 for Opioid abuse, uncomplicated
  • BILLABLE CODE - Use F11.11 for Opioid abuse, in remission
  • NON-BILLABLE CODE - F11.12 for Opioid abuse with intoxication
  • BILLABLE CODE - Use F11.120 for Opioid abuse with intoxication, uncomplicated
  • BILLABLE CODE - Use F11.121 for Opioid abuse with intoxication delirium
  • BILLABLE CODE - Use F11.122 for Opioid abuse with intoxication with perceptual disturbance
  • BILLABLE CODE - Use F11.129 for Opioid abuse with intoxication, unspecified
  • BILLABLE CODE - Use F11.13 for Opioid abuse with withdrawal
  • BILLABLE CODE - Use F11.14 for Opioid abuse with opioid-induced mood disorder
  • NON-BILLABLE CODE - F11.15 for Opioid abuse with opioid-induced psychotic disorder
  • BILLABLE CODE - Use F11.150 for Opioid abuse with opioid-induced psychotic disorder with delusions
  • BILLABLE CODE - Use F11.151 for Opioid abuse with opioid-induced psychotic disorder with hallucinations
  • BILLABLE CODE - Use F11.159 for Opioid abuse with opioid-induced psychotic disorder, unspecified
  • NON-BILLABLE CODE - F11.18 for Opioid abuse with other opioid-induced disorder
  • BILLABLE CODE - Use F11.181 for Opioid abuse with opioid-induced sexual dysfunction
  • BILLABLE CODE - Use F11.182 for Opioid abuse with opioid-induced sleep disorder
  • BILLABLE CODE - Use F11.188 for Opioid abuse with other opioid-induced disorder
  • BILLABLE CODE - Use F11.19 for Opioid abuse with unspecified opioid-induced disorder

Tabular List of Diseases and Injuries

The Tabular List of Diseases and Injuries is a list of ICD-10 codes, organized "head to toe" into chapters and sections with coding notes and guidance for inclusions, exclusions, descriptions and more. The following references are applicable to the code F11.1:


Type 1 Excludes

Type 1 Excludes
A type 1 excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.

Clinical Information

Information for Patients


Opioid Abuse 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:

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 abuse the medicines. Abuse 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 abuse, addiction, and overdoses are serious public health problems in the United States. Another problem is that more women are abusing opioids during pregnancy. This can lead to babies being addicted and going through withdrawal, known as neonatal abstinence syndrome (NAS). Opioid abuse 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


[Learn More in MedlinePlus]

Prescription Drug Abuse

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

Abusing 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 abuse 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]

Code History

  • 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)