2025 ICD-10-CM Diagnosis Code Z81.3
Family history of other psychoactive substance abuse and dependence
- ICD-10-CM Code:
- Z81.3
- ICD-10 Code for:
- Family history of psychoactv substance abuse and dependence
- Is Billable?
- Yes - Valid for Submission
- Code Navigator:
Z81.3 is a billable diagnosis code used to specify a medical diagnosis of family history of other psychoactive substance abuse and dependence. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2024 through September 30, 2025. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.
This code describes a circumstance which influences the patient's health status but not a current illness or injury. The code is unacceptable as a principal diagnosis.
Approximate Synonyms
The following list of clinical terms are approximate synonyms, alternative descriptions, or common phrases that might be used by patients, healthcare providers, or medical coders to describe the same condition. These synonyms and related diagnosis terms are often used when searching for an ICD-10 code, especially when the exact medical terminology is unclear. Whether you're looking for lay terms, similar diagnosis names, or common language alternatives, this list can help guide you to the correct ICD-10 classification.
- Both parents misuse drugs
- Drug misuse by mother
- Family history of substance abuse
- Paternal drug misuse
Clinical Classification
Clinical Classifications group individual ICD-10-CM diagnosis codes into broader, clinically meaningful categories. These categories help simplify complex data by organizing related conditions under common clinical themes.
They are especially useful for data analysis, reporting, and clinical decision-making. Even when diagnosis codes differ, similar conditions can be grouped together based on their clinical relevance. Each category is assigned a unique CCSR code that represents a specific clinical concept, often tied to a body system or medical specialty.
Personal/family history of disease
CCSR Code: FAC021
Inpatient Default: X - Not applicable.
Outpatient Default: Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.
Tabular List of Diseases and Injuries
The following annotation back-references are applicable to this diagnosis code. The Tabular List of Diseases and Injuries is a list of ICD-10-CM codes, organized "head to toe" into chapters and sections with coding notes and guidance for inclusions, exclusions, descriptions and more.
Inclusion Terms
Inclusion TermsThese terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
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).
- - History
- - family (of) - See Also: History, personal (of);
- - drug abuse NEC - Z81.3
- - psychoactive substance abuse NEC - Z81.3
- - substance abuse NEC - Z81.4
- - drug NEC - Z81.3
- - psychoactive NEC - Z81.3
- - family (of) - See Also: History, personal (of);
Code Edits
The Medicare Code Editor (MCE) detects errors and inconsistencies in ICD-10-CM diagnosis coding that can affect Medicare claim validity. These Medicare code edits help medical coders and billing professionals determine when a diagnosis code is not appropriate as a principal diagnosis, does not meet coverage criteria. Use this list to verify whether a code is valid for Medicare billing and to avoid claim rejections or denials due to diagnosis coding issues.
Unacceptable principal diagnosis
There are selected codes that describe a circumstance which influences an individual's health status but not a current illness or injury, or codes that are not specific manifestations but may be due to an underlying cause. These codes are considered unacceptable as a principal diagnosis.
Present on Admission (POA)
Z81.3 is exempt from POA reporting - The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement. Review other POA exempt codes here.
CMS POA Indicator Options and Definitions
POA Indicator: Y
Reason: Diagnosis was present at time of inpatient admission.
CMS Pays CC/MCC DRG? YES
POA Indicator: N
Reason: Diagnosis was not present at time of inpatient admission.
CMS Pays CC/MCC DRG? NO
POA Indicator: U
Reason: Documentation insufficient to determine if the condition was present at the time of inpatient admission.
CMS Pays CC/MCC DRG? NO
POA Indicator: W
Reason: Clinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission.
CMS Pays CC/MCC DRG? YES
POA Indicator: 1
Reason: Unreported/Not used - Exempt from POA reporting.
CMS Pays CC/MCC DRG? NO
Convert Z81.3 to ICD-9-CM
Below are the ICD-9 codes that most closely match this ICD-10 code, based on the General Equivalence Mappings (GEMs). This ICD-10 to ICD-9 crosswalk tool is helpful for coders who need to reference legacy diagnosis codes for audits, historical claims, or approximate code comparisons.
Family hx-condition NEC
ICD-9-CM: V19.8
Approximate Flag - The approximate mapping means this ICD-10 code does not have an exact ICD-9 equivalent. The matched code is the closest available option, but it may not fully capture the original diagnosis or clinical intent.
Patient Education
Drug Use and Addiction
What are drugs?
Drugs are chemical substances that can change how your body and mind work. They include prescription medicines, over-the-counter medicines, alcohol, tobacco, and illegal drugs.
What is drug use?
Drug use, or misuse, includes:
- Using illegal substances, such as
- Anabolic steroids
- Club drugs
- Cocaine
- Heroin
- Inhalants
- Marijuana
- Methamphetamines
- Misusing prescription medicines, including opioids. This means taking the medicines in a different way than the health care provider prescribed. This includes
- Taking a medicine that was prescribed for someone else
- Taking a larger dose than you are supposed to
- Using the medicine in a different way than you are supposed to. For example, instead of swallowing your tablets, you might crush and then snort or inject them.
- Using the medicine for another purpose, such as getting high
- Misusing over-the-counter medicines, including using them for another purpose and using them in a different way than you are supposed to
Drug use is dangerous. It can harm your brain and body, sometimes permanently. It can hurt the people around you, including friends, families, kids, and unborn babies. Drug use can also lead to addiction.
What is drug addiction?
Drug addiction is a chronic brain disease. It causes a person to take drugs repeatedly, despite the harm they cause. Repeated drug use can change the brain and lead to addiction.
The brain changes from addiction can be lasting, so drug addiction is considered a "relapsing" disease. This means that people in recovery are at risk for taking drugs again, even after years of not taking them.
Does everyone who takes drugs become addicted?
Not everyone who uses drugs becomes addicted. Everyone's bodies and brains are different, so their reactions to drugs can also be different. Some people may become addicted quickly, or it may happen over time. Other people never become addicted. Whether or not someone becomes addicted depends on many factors. They include genetic, environmental, and developmental factors.
Who is at risk for drug addiction?
Various risk factors can make you more likely to become addicted to drugs, including:
- Your biology. People can react to drugs differently. Some people like the feeling the first time they try a drug and want more. Others hate how it feels and never try it again.
- Mental health problems. People who have untreated mental health problems, such as depression, anxiety, or attention deficit/hyperactivity disorder (ADHD) are more likely to become addicted. This can happen because drug use and mental health problems affect the same parts of the brain. Also, people with these problems may use drugs to try to feel better.
- Trouble at home. If your home is an unhappy place or was when you were growing up, you might be more likely to have a drug problem.
- Trouble in school, at work, or with making friends. You might use drugs to get your mind off these problems.
- Hanging around other people who use drugs. They might encourage you to try drugs.
- Starting drug use when you're young. When kids use drugs, it affects how their bodies and brains finish growing. This increases your chances of becoming addicted when you're an adult.
What are the signs that someone has a drug problem?
Signs that someone has a drug problem include:
- Changing friends a lot
- Spending a lot of time alone
- Losing interest in favorite things
- Not taking care of themselves - for example, not taking showers, changing clothes, or brushing their teeth
- Being really tired and sad
- Eating more or eating less than usual
- Being very energetic, talking fast, or saying things that don't make sense
- Being in a bad mood
- Quickly changing between feeling bad and feeling good
- Sleeping at strange hours
- Missing important appointments
- Having problems at work or at school
- Having problems in personal or family relationships
What are the treatments for drug addiction?
Treatments for drug addiction include counseling, medicines, or both. Research shows that combining medicines with counseling gives most people the best chance of success.
The counseling may be individual, family, and/or group therapy. It can help you:
- Understand why you got addicted
- See how drugs changed your behavior
- Learn how to deal with your problems so you won't go back to using drugs
- Learn to avoid places, people, and situations where you might be tempted to use drugs
Medicines can help with the symptoms of withdrawal. For addiction to certain drugs, there are also medicines that can help you re-establish normal brain function and decrease your cravings.
If you have a mental disorder along with an addiction, it is known as a dual diagnosis. It is important to treat both problems. This will increase your chance of success.
If you have a severe addiction, you may need hospital-based or residential treatment. Residential treatment programs combine housing and treatment services.
Can drug use and addiction be prevented?
Drug use and addiction are preventable. Prevention programs involving families, schools, communities, and the media may prevent or reduce drug use and addiction. These programs include education and outreach to help people understand the risks of drug use.
NIH: National Institute on Drug Abuse
[Learn More in MedlinePlus]
Family History
Your family history includes health information about you and your close relatives. Families have many factors in common, including their genes, environment, and lifestyle. Looking at these factors can help you figure out whether you have a higher risk for certain health problems, such as heart disease, stroke, and cancer.
Having a family member with a disease raises your risk, but it does not mean that you will definitely get it. Knowing that you are at risk gives you a chance to reduce that risk by following a healthier lifestyle and getting tested as needed.
You can get started by talking to your relatives about their health. Draw a family tree and add the health information. Having copies of medical records and death certificates is also helpful.
Centers for Disease Control and Prevention
[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.