F10.120

HCC Category Mapping

What This Code Means

This code describes a patient who misuses alcohol and is currently in a state of intoxication without any serious complications like seizures or delirium. It indicates problematic drinking behavior that has led to being under the influence of alcohol.

Coding Tips

• •Verify documentation clearly states 'alcohol abuse' (not dependence) and 'intoxication' to distinguish from F10.020 (alcohol dependence with intoxication)
• •Ensure the intoxication is documented as 'uncomplicated' - if seizures, delirium, or other complications are present, use a different 5th character code (F10.121, F10.129, etc.)

Clinical Significance

This code captures alcohol abuse with uncomplicated intoxication, documenting an acute episode of alcohol intoxication in a patient with an established pattern of alcohol abuse. Accurate coding of the use level (abuse) and intoxication status is critical for tracking substance use severity and ensuring appropriate risk adjustment.

Documentation Requirements

• ✓Documentation of a maladaptive pattern of alcohol use with clinically significant impairment or distress (recurrent use causing role failure, hazardous use, legal problems, or social/interpersonal problems)
• ✓Confirmation that criteria for alcohol dependence are NOT met (no tolerance, withdrawal, or compulsive use pattern)
• ✓Documentation of acute intoxication at the time of the encounter, with clinical findings (e.g., blood alcohol level, slurred speech, impaired coordination)
• ✓Assessment and plan addressing alcohol use disorder with treatment recommendations (counseling, medication-assisted treatment, referral, etc.)

Commonly Confused Codes