F11.90 — Opioid use, unspecified, uncomplicated
F11.90 is a billable, specific ICD-10-CM code for opioid use, unspecified, uncomplicated. It is valid for submission on a claim.
Risk adjustment
F11.90 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.
Medicare coverage
F11.90 is named in 11 Medicare coverage policies — 10 listing it as supporting medical necessity, and 1 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
- A56645Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
- A56818Billing and Coding: Urine Drug Testing
- A56937Billing and Coding: Psychiatry and Psychology Services
How F11.90 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 F11.90.
- Use›opioid
Related codes at this level
Codes that share F11.9. If F11.90 is not quite right, the correct code is usually one of these.
- F11.91Opioid use, unspecified, in remission
- F11.92Opioid use, unspecified with intoxication
- F11.93Opioid use, unspecified with withdrawal
- F11.94Opioid use, unspecified with opioid-induced mood disorder
- F11.95Opioid use, unspecified with opioid-induced psychotic disorder
- F11.98Opioid use, unspecified with other specified opioid-induced disorder
- F11.99Opioid use, unspecified with unspecified opioid-induced disorder
Questions about F11.90
- Is F11.90 a billable ICD-10-CM code?
- Yes. F11.90 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does F11.90 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).