F13.11 — Sedative, hypnotic or anxiolytic abuse, in remission
F13.11 is a billable, specific ICD-10-CM code for sedative, hypnotic or anxiolytic abuse, in remission. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Sedative, hypnotic or anxiolytic use disorder, mild, in early remission
- Sedative, hypnotic or anxiolytic use disorder, mild, in sustained remission
Risk adjustment
F13.11 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 138 Drug Use Disorder, Mild, Uncomplicated, Except Cannabis0.423 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
F13.11 is named in 13 Medicare coverage policies — 11 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
- A59718Billing and Coding: Opioid Treatment Programsnot covered
- A54799Billing and Coding: Urine Drug Testing
- A55001Billing and Coding: Urine Drug Testing
How F13.11 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 F13.11.
- Abuse›drug NEC›sedative, hypnotic or anxiolytic›in remission(early) (sustained)
- Disorder›sedative, hypnotic, or anxiolytic use›mild›in remission(early) (sustained)
Related codes at this level
Codes that share F13.1. If F13.11 is not quite right, the correct code is usually one of these.
- F13.10Sedative, hypnotic or anxiolytic abuse, uncomplicated
- F13.12Sedative, hypnotic or anxiolytic abuse with intoxication
- F13.13Sedative, hypnotic or anxiolytic abuse with withdrawal
- F13.14Sedative, hypnotic or anxiolytic abuse with sedative, hypnotic or anxiolytic-induced mood disorder
- F13.15Sedative, hypnotic or anxiolytic abuse with sedative, hypnotic or anxiolytic-induced psychotic disorder
- F13.18Sedative, hypnotic or anxiolytic abuse with other sedative, hypnotic or anxiolytic-induced disorders
- F13.19Sedative, hypnotic or anxiolytic abuse with unspecified sedative, hypnotic or anxiolytic-induced disorder
Questions about F13.11
- Is F13.11 a billable ICD-10-CM code?
- Yes. F13.11 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does F13.11 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).