Substance use disorders are coded in the F10 to F19 range, one block per substance. Within each block, mild use disorder maps to the abuse code (for example F10.10 for alcohol) and moderate to severe maps to the dependence code (for example F10.20). Remission is the .21 dependence code.
Quick Reference: F10 to F19 Substance Blocks
| Block | Substance | Notes |
|---|---|---|
| F10 | Alcohol | Abuse F10.10 / dependence F10.20 |
| F11 | Opioid | Abuse F11.10 / dependence F11.20 |
| F12 | Cannabis | Abuse F12.10 / dependence F12.20 |
| F13 | Sedative, hypnotic, or anxiolytic | Abuse F13.10 / dependence F13.20 |
| F14 | Cocaine | Abuse F14.10 / dependence F14.20 |
| F15 | Other stimulant (incl. amphetamines) | Abuse F15.10 / dependence F15.20 |
| F16 | Hallucinogen | Abuse F16.10 / dependence F16.20 |
| F17 | Nicotine | Dependence codes only; no abuse code |
| F18 | Inhalant | Abuse F18.10 / dependence F18.20 |
| F19 | Other, psychoactive, or unknown | Abuse F19.10 / dependence F19.20 |
Each block follows the same internal pattern. Using alcohol (F10) as the worked example, DSM-5 severity determines whether you reach for the abuse or the dependence code:
| Presentation | Maps to | Code | Notes |
|---|---|---|---|
| DSM-5 mild (2 to 3 criteria) | Abuse | F10.10 | Alcohol abuse, uncomplicated |
| DSM-5 moderate or severe (4+ criteria) | Dependence | F10.20 | Alcohol dependence, uncomplicated |
| In remission | Dependence, in remission | F10.21 | Remission is tracked under the dependence codes |
| With intoxication | Dependence, complicated | F10.120 | Example of a complicated sixth-character code |
The core rule: DSM-5 mild maps to the abuse (.10) code; DSM-5 moderate and severe both map to the dependence (.20) code. ICD-10-CM does not distinguish moderate from severe.
How the F10 to F19 Blocks Work
ICD-10-CM assigns one three-character block to each substance class, from F10 (alcohol) through F19 (other, psychoactive, or unknown substances). Once you have the right block for the substance, the rest of the code is built the same way regardless of which substance you are coding:
- The block sets the substance. F11 is opioids, F12 is cannabis, F14 is cocaine, and so on. F19 is the catch-all for other, multiple, unknown, or psychoactive substances.
- The fourth character sets the pattern. A "1" indicates abuse and a "2" indicates dependence. So F10.1x is alcohol abuse and F10.2x is alcohol dependence.
- Further characters set the complication. Additional characters specify intoxication, withdrawal, or an induced disorder. The plain "uncomplicated" codes end in .10 (abuse) and .20 (dependence).
Because the structure is consistent, learning the alcohol (F10) pattern lets you code every other block by swapping the first two digits.
Abuse vs Dependence (DSM-5 Severity Mapping)
ICD-10-CM predates the DSM-5 single-diagnosis model of "substance use disorder" with mild, moderate, and severe specifiers. The crosswalk between the two systems is fixed:
- DSM-5 mild (2 to 3 criteria) maps to the abuse code, ending in .10, for example F10.10 (alcohol abuse, uncomplicated).
- DSM-5 moderate (4 to 5 criteria) and severe (6 or more criteria) both map to the dependence code, ending in .20, for example F10.20 (alcohol dependence, uncomplicated).
There is no separate moderate versus severe code. Both moderate and severe substance use disorder collapse into the single dependence (.20) code. The severity distinction lives in your documentation, not in the code.
Uncomplicated vs Complicated
The plain abuse (.10) and dependence (.20) codes are the "uncomplicated" codes. They are correct only when there is no current intoxication, withdrawal, or substance-induced disorder. When a complication is present, you extend the code with further characters:
- F10.120 alcohol abuse with intoxication, uncomplicated.
- F10.14 alcohol abuse with alcohol-induced mood disorder.
- F10.20 alcohol dependence, uncomplicated (no current complication).
Billing note: reach for the uncomplicated .10 or .20 code unless your documentation supports a current intoxication, withdrawal, or induced disorder. If a complication is present, code it specifically rather than defaulting to the uncomplicated code.
Nicotine (F17) is the exception. The F17 block uses dependence codes only, with no abuse code. Use F17.200 (nicotine dependence, unspecified, uncomplicated) or F17.210 (nicotine dependence, cigarettes, uncomplicated). There is no F17.10 abuse code.
Coding Remission
Remission is tracked within the dependence subclassification, not the abuse codes. The remission code ends in .21:
- F10.21 alcohol dependence, in remission.
- F11.21 opioid dependence, in remission.
- F12.21 cannabis dependence, in remission.
Because remission lives under the dependence codes, a client whose use disorder is in remission is coded with the .21 dependence-in-remission code for the relevant block, even if the original presentation was documented as mild. Document early versus sustained remission in your note to support the code.
Documentation
Strong substance use disorder documentation should include:
Substance and DSM-5 severity: name the substance and the number of DSM-5 criteria met, so the abuse versus dependence mapping is defensible.
Complication status: whether current intoxication, withdrawal, or a substance-induced disorder is present, which drives the uncomplicated versus complicated code choice.
Remission status: whether the disorder is in early or sustained remission, which supports the .21 code.
Nicotine specifics: for F17, the product used (for example cigarettes) and the fact that only dependence codes apply.
Co-occurring conditions: any co-occurring mental health or additional substance diagnoses you are also coding, with the primary focus of treatment identified.
Frequently Asked Questions
- What is the ICD-10 code for alcohol use disorder?
- It depends on DSM-5 severity. Mild alcohol use disorder maps to the abuse code F10.10 (alcohol abuse, uncomplicated). Moderate to severe alcohol use disorder maps to the dependence code F10.20 (alcohol dependence, uncomplicated). Add further characters when intoxication, withdrawal, or a substance-induced disorder is present.
- How does DSM-5 severity map to ICD-10?
- DSM-5 mild use disorder (2 to 3 criteria) maps to the abuse code, which ends in .10 (for example F10.10). DSM-5 moderate (4 to 5 criteria) and severe (6 or more criteria) both map to the dependence code, which ends in .20 (for example F10.20). There is no separate moderate versus severe code in ICD-10-CM.
- What is the code for opioid use disorder?
- Opioid use disorder sits in the F11 block. Mild opioid use disorder maps to F11.10 (opioid abuse, uncomplicated) and moderate to severe maps to F11.20 (opioid dependence, uncomplicated). Add further characters for intoxication, withdrawal, or induced conditions.
- What is the code for cannabis use disorder?
- Cannabis use disorder sits in the F12 block. Mild cannabis use disorder maps to F12.10 (cannabis abuse, uncomplicated) and moderate to severe maps to F12.20 (cannabis dependence, uncomplicated).
- How do I code a substance use disorder in remission?
- Remission is coded within the dependence subclassification using the .21 code, for example F10.21 (alcohol dependence, in remission). Remission is not tracked under the abuse (.10) codes, so a client whose use disorder is in remission is coded with the .21 dependence-in-remission code for the relevant substance block.
Accurate substance use disorder coding starts with the block for the substance, then the DSM-5 severity mapping: mild to abuse (.10), moderate and severe to dependence (.20). Extend for complications, use the .21 code for remission, and remember nicotine (F17) uses dependence codes only.