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ICD-10 Coding for Polysubstance Use(F19.10, F19.20, F19.24)

Complete ICD-10-CM coding and documentation guide for Polysubstance Use. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

Multiple Substance UsePolydrug Use

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Related ICD-10 Code Ranges

Complete code families applicable to Polysubstance Use

F19.1-F19.9Primary Range

Mental and behavioral disorders due to multiple drug use and use of other psychoactive substances

This range covers disorders related to the use of multiple substances, including dependence and withdrawal.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescriptionWhen to UseKey Documentation
F19.10Unspecified polysubstance use, uncomplicatedUse when the provider explicitly states 'use' without abuse or dependence.
  • Provider documentation of polysubstance use without signs of dependence or withdrawal
F19.20Polysubstance dependence, uncomplicatedUse when there is documented dependence, such as tolerance or withdrawal.
  • Documentation of tolerance or withdrawal symptoms
F19.24Polysubstance dependence with withdrawalUse when withdrawal symptoms are documented with standardized scales.
  • Withdrawal symptoms documented with standardized scales (e.g., CIWA, COWS)

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

Essential facts and insights about Polysubstance Use

The ICD-10 code for unspecified polysubstance use is F19.10. For dependence, use F19.20, and for dependence with withdrawal, use F19.24.

Primary ICD-10-CM Codes for polysubstance use

F19.10
Unspecified polysubstance use, uncomplicated
Billable Code

Decision Criteria

documentation Criteria

  • Explicit mention of 'use' without dependence or withdrawal

Applicable To

  • Polysubstance use without dependence or withdrawal

Excludes

  • Specific substance use disorders

Clinical Validation Requirements

  • Provider documentation of polysubstance use without signs of dependence or withdrawal

Code-Specific Risks

  • Risk of under-coding if dependence or withdrawal is present

Coding Notes

  • Ensure documentation specifies 'use' without additional qualifiers.
View Full Code Details

Ancillary Codes

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

Poisoning by heroin, accidental (unintentional), initial encounter

T40.1X1A
Use to specify substances involved in polysubstance dependence.

Poisoning by cocaine, accidental (unintentional), initial encounter

T40.5X1A
Use to specify substances involved in polysubstance withdrawal.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Polysubstance dependence, uncomplicated

F19.20
Use F19.20 if there is documented dependence, such as tolerance or withdrawal.

Unspecified polysubstance use, uncomplicated

F19.10
Use F19.10 if there is no documented dependence or withdrawal.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting Polysubstance Use to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code F19.10.

Impact

Clinical: Inadequate treatment planning, Regulatory: Potential audit issues, Financial: Underpayment due to incorrect coding

Mitigation Strategy

Specify each substance, Document usage patterns

Impact

Reimbursement: Potential underpayment due to incorrect DRG assignment, Compliance: Non-compliance with coding guidelines, Data Quality: Inaccurate clinical data representation

Mitigation Strategy

Code F19.20 or F19.24 with specific substance codes

Impact

Failure to document specific substances can lead to audit findings.

Mitigation Strategy

Ensure all substances are documented and coded.

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, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Polysubstance Use

Use these documentation templates to ensure complete and accurate documentation for Polysubstance Use. These templates include all required elements for proper coding and billing.

Polysubstance dependence with withdrawal

Specialty: Addiction Medicine

Required Elements

  • Substances used
  • Route and frequency
  • Withdrawal symptoms
  • Standardized scale scores

Example Documentation

Patient presents with heroin and cocaine dependence, experiencing tremors and nausea. HR 112, BP 150/95, CIWA 14.

Examples: Poor vs. Good Documentation

Poor Documentation Example
Patient uses multiple drugs.
Good Documentation Example
Polysubstance dependence involving heroin (daily IV use) and cocaine (weekly intranasal use) with withdrawal symptoms: diaphoresis, HR 110, CIWA score 12.
Explanation
The good example specifies substances, usage patterns, and withdrawal symptoms, meeting documentation requirements.

Need help with ICD-10 coding for Polysubstance Use? Ask your questions below.

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