Is F11.25 a billable ICD-10-CM code?

No. F11.25 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does F11.25 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 F11.25?

F11.25 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 F11.25 (F11.2) and apply to it just the same.

F11.25

F11.25 — Opioid dependence with opioid-induced psychotic disorder

Non-billable headerICD-10-CM

F11.25 is a non-billable header ICD-10-CM code for opioid dependence with opioid-induced psychotic disorder. It cannot be billed on its own: choose one of the more specific child codes below.

Excludes1 inherited from the categories above F11.25

These are not written on F11.25, but they bind it: a note on a category applies to every code beneath it. Billing F11.25 with anything listed here is a denial.

Written on F11.2 — Opioid dependence

opioid abuse (F11.1-)
opioid use, unspecified (F11.9-)

Excludes2 inherited from the categories above F11.25

Also inherited, and the opposite of Excludes1: these conditions are not part of F11.25, but a patient can have both, so you may code both.

Written on F11.2 — Opioid dependence

opioid poisoning (T40.0-T40.2-)

Risk adjustment

F11.25 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 history

F11.25 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Code to one of these instead F11.25

3 child codes. Green means billable.

Related codes at this level

Codes that share F11.2. If F11.25 is not quite right, the correct code is usually one of these.

Questions about F11.25

Is F11.25 a billable ICD-10-CM code?: No. F11.25 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does F11.25 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 F11.25?: F11.25 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 F11.25 (F11.2) and apply to it just the same.