F11.93 — Opioid use, unspecified with withdrawal
F11.93 is a billable, specific ICD-10-CM code for opioid use, unspecified with withdrawal. It is valid for submission on a claim.
Excludes1 — never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- opioid use, unspecified with intoxication (F11.92-)
Other codes that can never be billed with F11.93
These codes carry an Excludes1 note pointing at F11.93. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading F11.93 alone.
- F11.92Opioid use, unspecified with intoxication
Risk adjustment
F11.93 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
F11.93 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
- A56756Billing and Coding: Home Health - Psychiatric Care
- A56818Billing and Coding: Urine Drug Testing
How F11.93 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 F11.93.
- Abstinence symptoms, syndrome›opioid
- Use›opioid›with›withdrawal
Related codes at this level
Codes that share F11.9. If F11.93 is not quite right, the correct code is usually one of these.
- F11.90Opioid use, unspecified, uncomplicated
- F11.91Opioid use, unspecified, in remission
- F11.92Opioid use, unspecified with intoxication
- 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 F11.93
- Is F11.93 a billable ICD-10-CM code?
- Yes. F11.93 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does F11.93 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 F11.93?
- F11.93 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.