Is ICD-10-CM code F13 billable?

No, F13 (Sedative, hypnotic, or anxiolytic related disorders) is a non-billable ICD-10-CM code. It must be coded to a more specific subcategory before it can be used for reimbursement.

What chapter does ICD-10-CM code F13 belong to?

F13 belongs to Chapter 5 of the ICD-10-CM tabular list: F01–F99 (Mental, Behavioral and Neurodevelopmental Disorders).

F13Not billable, use a more specific code below

Sedative, hypnotic, or anxiolytic related disorders

In Mental and behavioral disorders due to psychoactive substance use (F10-F19), chapter 5: Mental, Behavioral and Neurodevelopmental Disorders

58 billable codes under F13: 30 are a CC; 56 map to HCC 137 (Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications), HCC 135 (Drug Use with Psychotic Complications), HCC 138 (Drug Use Disorder, Mild, Uncomplicated, Except Cannabis).A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment. An HCC counts toward a Medicare Advantage patient's risk score.

Official coding guidelines

From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.

Section I.C.5.b Mental and behavioral disorders due to psychoactive substance use (page 43), covers F13
Code only one pattern per substance: dependence outranks abuse and use, and abuse outranks use. Remission and unspecified use codes need provider documentation; code medical conditions separately with the substance code.

All codes under F13

F13 can't be used on a claim. Pick a billable code below; grey headings group them.

F13 MS-DRGs

As the principal diagnosis, the billable codes under F13 group to MS-DRG 894, 895, 896, 897, 791, or 793 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

DRG 894 Alcohol, Drug Abuse or Dependence, Left AMA (58 of 58 codes)
DRG 895 Alcohol, Drug Abuse or Dependence with Rehabilitation Therapy (58 of 58 codes)
DRG 896 Alcohol, Drug Abuse or Dependence without Rehabilitation Therapy with MCC (58 of 58 codes)
DRG 897 Alcohol, Drug Abuse or Dependence without Rehabilitation Therapy without MCC (58 of 58 codes)
DRG 791 Prematurity with Major Problems (12 of 58 codes)
DRG 793 Full Term Neonate with Major Problems (12 of 58 codes)

Other codes that refer to F13

Notes on these codes point to F13.

F44.0 Excludes2: alcohol-or other psychoactive substance-induced amnestic disorder (F10, F13, F19 with .26, .96)

About the condition

Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.

Prescription Drug Misuse

If you take a medicine in a different way than your health care provider prescribed, it's called prescription drug misuse. It could be: Misusing some prescription drugs can lead to addiction. These include opioids, sedatives, tranquilizers, and stimulants. Drug addiction is a chronic brain disease. It causes a person to take drugs repeatedly despite the harm they cause.

Code history

Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.