2025 ICD-10-CM code F11.122
Opioid abuse with intoxication with perceptual disturbance. This condition involves the excessive use of opioids, along with the presence of intoxication and perceptual disturbances like hallucinations.
Medical necessity is established by the presence of a diagnosable opioid abuse disorder, current intoxication, and perceptual disturbances requiring medical intervention.The documentation should clearly link the opioid abuse to the intoxication and perceptual disturbances.
Providers diagnose this condition based on patient history, signs and symptoms, a thorough assessment of personal and social behavior, and physical examination. Treatment may include behavioral therapy, counseling, group therapy, residential treatment, breathing support (if necessary), and naloxone administration to counteract opioid effects in case of intoxication.
In simple words: This code describes someone who is abusing opioids, is currently intoxicated (high) on opioids, and is experiencing distorted perceptions, like hallucinations.Opioid abuse means using opioids too much and having problems because of it, affecting their job, relationships, and other parts of life.
Opioid abuse with intoxication with perceptual disturbance refers to a pattern of excessive opioid use that negatively impacts an individual's health, work, school, family, and social life.Individuals may disregard obligations, fail to meet commitments, and engage in risky behaviors. Intoxication indicates high opioid levels in the body causing perceptual disturbances such as hallucinations, alongside potential respiratory, nervous system, psychological, and cardiac problems.
Example 1: A 25-year-old patient presents to the emergency department with rapid breathing, dilated pupils, and reports seeing spiders crawling on the walls.He admits to abusing prescription painkillers.He exhibits slurred speech and disorientation.The physician diagnoses opioid abuse with intoxication with perceptual disturbance., A 38-year-old woman with a history of opioid abuse is brought in by family members who report she has been acting strangely, talking to people who aren't there, and seems confused.She appears intoxicated and a urine drug screen is positive for opioids.She is diagnosed with F11.122., A patient undergoing treatment for chronic pain develops a tolerance to their prescribed opioid medication and begins taking more than prescribed. They start experiencing hallucinations and neglecting their responsibilities at home and work. This is indicative of opioid abuse with intoxication and perceptual disturbances.
Documentation should include evidence of opioid abuse (pattern of excessive use, negative impacts on life), current intoxication (physical exam findings, drug screen), and perceptual disturbances (patient report, observation of hallucinations or other sensory distortions).
- Payment Status: Billable
- Specialties:Addiction Medicine, Emergency Medicine, Psychiatry, Internal Medicine, Family Medicine
- Place of Service:Inpatient Hospital, Emergency Room - Hospital, Office, Outpatient Hospital, Telehealth Provided in Patient’s Home,Residential Substance Abuse Treatment Facility