F11.281: Opioid dependence with opioid-induced sexual dysfunction
F11.281 is a billable, specific ICD-10-CM code for opioid dependence with opioid-induced sexual dysfunction. It is valid for submission on a claim.
Check F11.281 with the rest of the claim: free scrubberExcludes1 inherited from the categories above F11.281
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above F11.281
Not part of this code, but both may be coded when both are present.
Risk adjustment
F11.281 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. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
F11.281 is named in 22 Medicare coverage policies: 21 listing it as supporting medical necessity, and 1 listing it as NOT covered. Which one applies depends on your Medicare contractor.
- A52434Health and Behavior Assessment/Intervention – Medical Policy Articlenot covered
- A54799Billing and Coding: Urine Drug Testing
- A55001Billing and Coding: Urine Drug Testing
- A56645Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
Alphabetic index entries that lead here
- Opioid›induced, without use disorder›sexual dysfunction
- Dependence›drug NEC›opioid›with›sexual dysfunction
- Dysfunction›sexual›opioid›in›dependence
- Disorder›opioid use›moderate or severe›with›opioid-induced›sexual dysfunction
Code history
Unchanged in every release from FY2024 to FY2027.