2025 ICD-10-CM code F11.10
Opioid abuse, uncomplicated.A mild opioid use disorder.
Medical necessity for treatment is established by the presence of opioid abuse and its negative impact on the patient's health and well-being.Documentation supporting the need for intervention and treatment is crucial.
Providers diagnose the condition based on the patient’s history, signs and symptoms, a detailed inquiry into the individual’s personal and social behavior, and physical examination. Laboratory studies may include blood tests for opioid levels. Treatment approaches include behavioral therapy, counseling, group therapy, admission to a residential treatment center, and administration of naloxone to block the effect of the drug if the patient is intoxicated.
- Mental, Behavioral and Neurodevelopmental disorders (F01-F99)
- F11.1 Opioid abuse Includes:Nondependent opioid abuseOpioid use disorder, mild
In simple words: Opioid abuse that doesn't cause severe complications like delirium, mood disorders, or psychosis, but still negatively impacts daily life, such as work, school, family, and social interactions.The person may struggle to control their opioid use despite knowing its harmful effects.
Uncomplicated opioid abuse refers to excessive use that jeopardizes health and negatively affects work, school, family, and social life. Individuals ignore obligations and fail to meet commitments and may take unnecessary risks or engage in dangerous or illegal behaviors but not to the extent that the abuse results in intoxication with delirium or mood disorders, psychoses, or other complications.
Example 1: A 25-year-old patient admits to using prescription painkillers recreationally for several months. They have missed work due to their opioid use and their family relationships are strained, but they deny experiencing severe withdrawal symptoms or other significant medical complications., A 40-year-old patient is seeking help for their opioid use. They report using opioids for pain relief but admit to taking higher doses than prescribed. Their opioid use impacts their ability to fulfill their daily responsibilities. They exhibit mild withdrawal symptoms when they try to stop., A teenager is brought in by their parents who suspect opioid abuse. The teenager admits to using opioids occasionally with friends and has experienced a decline in school performance and social interactions, but denies any serious medical issues related to their opioid use.
Documentation should include evidence of opioid abuse impacting social, occupational, or other areas of functioning.The type of opioid used, frequency, and quantity should be noted, along with any associated symptoms or consequences.
- Payment Status: Active
- Specialties:Addiction medicine, psychiatry, primary care, pain management
- Place of Service:Office, Inpatient Hospital, Outpatient Hospital, Residential Substance Abuse Treatment Facility,Community Mental Health Center, Telehealth Provided in Patient's Home