ICD-10 Coding for Polysubstance Use Disorder(F19.10, F19.20)
Complete ICD-10-CM coding and documentation guide for Polysubstance Use Disorder. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Polysubstance Use Disorder
F19.1-F19.9Primary Range
Mental and behavioral disorders due to multiple drug use and use of other psychoactive substances
This range includes codes for polysubstance use, abuse, dependence, and related conditions.
Poisoning by narcotics and psychodysleptics [hallucinogens]
These codes are used for documenting poisoning and toxic effects related to substance use.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| F19.10 | Mental and behavioral disorders due to multiple drug use and use of other psychoactive substances, uncomplicated | Use when multiple substances are used but do not meet criteria for abuse or dependence. |
|
| F19.20 | Dependence syndrome | Use when dependence criteria are met for multiple 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 use disorder
Essential facts and insights about Polysubstance Use Disorder
Primary ICD-10-CM Codes for polysubstance use disorder
Decision Criteria
clinical Criteria
- Multiple substances used without meeting abuse or dependence criteria.
Applicable To
- Polysubstance use without complications
Excludes
- Substance-specific disorders (F10-F18)
Clinical Validation Requirements
- Documentation of multiple substances used
- No criteria for abuse or dependence met
Code-Specific Risks
- Risk of undercoding if abuse or dependence criteria are met.
Coding Notes
- Ensure documentation specifies each substance and pattern of use.
F19.20 - Dependence syndrome
Use when dependence criteria are met for multiple substances.
Applicable To
- Polysubstance dependence
Excludes
- Substance-specific dependence (F10-F18)
Clinical Validation Requirements
- Documentation of tolerance, withdrawal, or continued use despite harm
Coding Notes
Document specific substances and evidence of dependence.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Polysubstance Use Disorder to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code F19.10.
Impact
Clinical: Inaccurate patient records., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Use specific terms for each substance., Document patterns and effects of use.
Impact
Reimbursement: May lead to claim denials due to lack of specificity., Compliance: Non-compliance with ICD-10 documentation standards., Data Quality: Poor data quality affecting patient records.
Mitigation Strategy
Specify each substance and pattern of use in documentation.
Impact
Lack of specific substance documentation can trigger audits.
Mitigation Strategy
Ensure all substances and patterns of use are documented.
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 Use Disorder, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Polysubstance Use Disorder
Use these documentation templates to ensure complete and accurate documentation for Polysubstance Use Disorder. These templates include all required elements for proper coding and billing.
Polysubstance dependence with withdrawal
Specialty: PsychiatryRequired Elements
- Substances used
- Pattern of use
- Withdrawal symptoms
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Polysubstance Use Disorder? Ask your questions below.