HCC 54 and HCC 55 – Substance AbuseJanuary 9, 2018
This month we’re taking a look at substance abuse, its definition, criteria, and the differences between use and dependence.
This is the code range for the conditions related to substance abuse:
|F13.1-F13.19||Sedative, hypnotic or anxiolytic abuse|
|F15.1-F15.19||Other stimulant abuse|
|F19.1-F19.19||Other psychoactive substance abuse|
Psychoactive substance abuse is the use of any substance for nontherapeutic purposes or the use of medication for purposes other than what it’s prescribed for, such as:
- Use of illicit drugs, like cocaine
- Misuse of prescribed drugs that stimulate or depress the central nervous system, like amphetamines or barbiturates
- Habitual use of substances that are commercially available with desired effects, like alcohol
The Differences Between Use and Dependence
When a psychoactive substance is used to treat a behavioral or mental health disorder.
For documentation purposes, psychoactive substance use must be linked to a mental health or behavioral disorder by a provider.
ICD-10 coding guidelines identify 3 criteria for a definite diagnosis of dependence:
ICD-10 coding guidelines also define a hierarchy of reportable psychoactive substance use, abuse, and dependence code designations. When multiple terms (use, abuse, and dependence) are found in provider documentation, only one ICD-10 code should be reported:
- If use and abuse are documented, report only the code for abuse.
- If use and dependence are documented, report only the code for dependence.
- If abuse and dependence are documented, report only the code for dependence.
- If use, abuse, and dependence are all documented, report only the code for dependence.
ICD-10-CM Expert for Physicians
McGraw-Hill concise dictionary of modern medicine ©2002