F10.130

HCC Category Mapping

What This Code Means

This code describes a patient who misuses alcohol and is experiencing withdrawal symptoms without serious complications like seizures or delirium. Withdrawal occurs when someone who regularly drinks alcohol suddenly stops or significantly reduces their intake.

Coding Tips

• •Verify documentation specifies 'uncomplicated' withdrawal - if seizures, delirium tremens, or hallucinations are present, use a different F10.13x code
• •Ensure the record documents both alcohol abuse (not just dependence) and active withdrawal symptoms to justify this combination code

Clinical Significance

This code captures alcohol abuse with uncomplicated withdrawal, indicating physiological dependence severe enough to produce withdrawal symptoms upon cessation or reduction of alcohol intake. Withdrawal codes carry significant risk adjustment implications and reflect high-acuity clinical scenarios.

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 withdrawal symptoms (tremor, diaphoresis, tachycardia, hypertension, anxiety, nausea, seizures) occurring after reduction or cessation of alcohol use
• ✓Assessment and plan addressing alcohol use disorder with treatment recommendations (counseling, medication-assisted treatment, referral, etc.)

Commonly Confused Codes