ICD-10 Coding for Polysubstance Dependence(F19.20, F19.21, F19.24)
Complete ICD-10-CM coding and documentation guide for Polysubstance Dependence. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Polysubstance Dependence
F10-F19Primary Range
Mental and behavioral disorders due to psychoactive substance use
This range includes codes for disorders related to the use of multiple substances, including polysubstance dependence.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| F19.20 | Polysubstance dependence, uncomplicated | Use when the patient is dependent on three or more substances without specifying a predominant substance. |
|
| F19.21 | Polysubstance dependence, in remission | Use when the patient is in remission from dependence on three or more substances. |
|
| F19.24 | Polysubstance dependence with withdrawal | Use when the patient is experiencing withdrawal from dependence on three or more substances. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for polysubstance dependence
Essential facts and insights about Polysubstance Dependence
Primary ICD-10-CM Codes for polysubstance dependence
Decision Criteria
clinical Criteria
- Patient uses three or more substances with documented dependence.
Applicable To
- Dependence on multiple substances without complications
Excludes
- Dependence on a single substance
Clinical Validation Requirements
- Documented use of three or more substances with dependence criteria met for each
- Evidence of withdrawal symptoms or tolerance
Code-Specific Risks
- Risk of under-documenting specific substances involved
Coding Notes
- Ensure all substances are documented and meet dependence criteria.
F19.21 - Polysubstance dependence, in remission
Use when the patient is in remission from dependence on three or more substances.
Applicable To
- Dependence on multiple substances in remission
Excludes
- Active dependence on a single substance
Clinical Validation Requirements
- Documented history of dependence on three or more substances
- Evidence of sustained remission
Coding Notes
Document the duration and status of remission clearly.
F19.24 - Polysubstance dependence with withdrawal
Use when the patient is experiencing withdrawal from dependence on three or more substances.
Applicable To
- Dependence on multiple substances with withdrawal symptoms
Excludes
- Withdrawal from a single substance
Clinical Validation Requirements
- Documented withdrawal symptoms from three or more substances
- Evidence of dependence on these substances
Coding Notes
Ensure withdrawal symptoms are clearly documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Long-term (current) use of opiate analgesics
Z79.891Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Polysubstance Dependence to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code F19.20.
Impact
Clinical: Inadequate treatment planning, Regulatory: Potential audit issues, Financial: Reduced reimbursement
Mitigation Strategy
Use structured templates, Include specific substance details
Impact
Reimbursement: Incorrect coding may lead to lower reimbursement., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate representation of patient condition.
Mitigation Strategy
Use F19.20 when dependence criteria are met for multiple substances.
Impact
Lack of specificity in documenting substances can lead to audit findings.
Mitigation Strategy
Use detailed documentation templates that specify each substance.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Polysubstance Dependence, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Polysubstance Dependence
Use these documentation templates to ensure complete and accurate documentation for Polysubstance Dependence. These templates include all required elements for proper coding and billing.
Patient with active polysubstance dependence
Specialty: Addiction MedicineRequired Elements
- Substance names
- Dependence status
- Withdrawal symptoms
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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