F11.129 — Opioid abuse with intoxication, unspecified
F11.129 is a billable, specific ICD-10-CM code for opioid abuse with intoxication, unspecified. It is valid for submission on a claim.
Excludes1 inherited from the categories above F11.129
These are not written on F11.129, but they bind it: a note on a category applies to every code beneath it. Billing F11.129 with anything listed here is a denial.
Risk adjustment
F11.129 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 137 Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications0.424 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.
Medicare coverage
F11.129 is named in 11 Medicare coverage policies — 9 listing it as supporting medical necessity, and 2 listing it as NOT covered. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52434Health and Behavior Assessment/Intervention – Medical Policy Articlenot covered
- A56562Billing and Coding: Health and Behavior Assessment/Interventionnot covered
- A56645Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
- A56818Billing and Coding: Urine Drug Testing
How F11.129 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to F11.129.
- Abuse›drug NEC›opioid›with›intoxication
- Disorder›opioid use›mild›with›opioid intoxication›without perceptual disturbances
Code history
F11.129 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.
Related codes at this level
Codes that share F11.12. If F11.129 is not quite right, the correct code is usually one of these.
Questions about F11.129
- Is F11.129 a billable ICD-10-CM code?
- Yes. F11.129 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does F11.129 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 F11.129?
- F11.129 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above F11.129 (F11.1) and apply to it just the same.