F11.1
F11.1 — Opioid abuse
Non-billable headerICD-10-CM
F11.1 is a non-billable header ICD-10-CM code for opioid abuse. It cannot be billed on its own: choose one of the more specific child codes below.
Other codes that can never be billed with F11.1
These codes carry an Excludes1 note pointing at F11.1. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading F11.1 alone.
Risk adjustment
F11.1 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Code to one of these instead F11.1
8 child codes. Green means billable.
- F11.10Opioid abuse, uncomplicated
- F11.11Opioid abuse, in remission
- F11.12Opioid abuse with intoxication
- F11.13Opioid abuse with withdrawal
- F11.14Opioid abuse with opioid-induced mood disorder
- F11.15Opioid abuse with opioid-induced psychotic disorder
- F11.18Opioid abuse with other opioid-induced disorder
- F11.19Opioid abuse with unspecified opioid-induced disorder
Related codes at this level
Codes that share F11. If F11.1 is not quite right, the correct code is usually one of these.
Questions about F11.1
- Is F11.1 a billable ICD-10-CM code?
- No. F11.1 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does F11.1 sit in the tabular list?
- Mental, Behavioral and Neurodevelopmental disorders (F01-F99), in the block Mental and behavioral disorders due to psychoactive substance use (F10-F19).
- What cannot be coded together with F11.1?
- F11.1 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.