F13.97 — Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced persisting dementia
F13.97 is a billable, specific ICD-10-CM code for sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced persisting dementia. 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-induced major neurocognitive disorder, without use disorder
Excludes1 inherited from the categories above F13.97
These are not written on F13.97, but they bind it: a note on a category applies to every code beneath it. Billing F13.97 with anything listed here is a denial.
Risk adjustment
F13.97 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 135 Drug Use with 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
F13.97 is named in 14 Medicare coverage policies — 12 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
- A56645Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
- A56756Billing and Coding: Home Health - Psychiatric Care
How F13.97 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 F13.97.
- Sedative, hypnotic, or anxiolytic-induced›major neurocognitive disorder
- Dementia›in›sedatives, hypnotics or anxiolytics
- Dementia›in›psychoactive drug›sedatives, hypnotics or anxiolytics
- Disorder›cognitive›persisting›due to›anxiolytics
- Disorder›cognitive›persisting›due to›hypnotics
- Disorder›cognitive›persisting›due to›sedatives
- Use›sedative, hypnotic, or anxiolytic›with›persisting›dementia
Code history
F13.97 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.
Related codes at this level
Codes that share F13.9. If F13.97 is not quite right, the correct code is usually one of these.
- F13.90Sedative, hypnotic, or anxiolytic use, unspecified, uncomplicated
- F13.91Sedative, hypnotic or anxiolytic use, unspecified, in remission
- F13.92Sedative, hypnotic or anxiolytic use, unspecified with intoxication
- F13.93Sedative, hypnotic or anxiolytic use, unspecified with withdrawal
- F13.94Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced mood disorder
- F13.95Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced psychotic disorder
- F13.96Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced persisting amnestic disorder
- F13.98Sedative, hypnotic or anxiolytic use, unspecified with other sedative, hypnotic or anxiolytic-induced disorders
- F13.99Sedative, hypnotic or anxiolytic use, unspecified with unspecified sedative, hypnotic or anxiolytic-induced disorder
Questions about F13.97
- Is F13.97 a billable ICD-10-CM code?
- Yes. F13.97 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does F13.97 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 F13.97?
- F13.97 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 F13.97 (F13.9) and apply to it just the same.