F10.231

HCC Category Mapping

What This Code Means

A person who is dependent on alcohol and is experiencing delirium during alcohol withdrawal, characterized by severe confusion and agitation.

Coding Tips

• •Withdrawal delirium is a medical emergency; ensure it is clearly documented as occurring during withdrawal, not intoxication
• •This code indicates a more severe withdrawal presentation than simple withdrawal

Clinical Significance

This code captures alcohol dependence with withdrawal delirium (delirium tremens), indicating physiological dependence severe enough to produce withdrawal symptoms upon cessation or reduction of alcohol intake. Withdrawal delirium (delirium tremens) is a life-threatening medical emergency with mortality rates of 1-5% even with treatment, requiring intensive monitoring. Withdrawal codes carry significant risk adjustment implications and reflect high-acuity clinical scenarios.

Documentation Requirements

• ✓Documentation of alcohol dependence with at least three of: tolerance, withdrawal, use in larger amounts/longer periods than intended, persistent desire or unsuccessful efforts to cut down, significant time spent obtaining/using/recovering, important activities given up, continued use despite knowledge of physical/psychological problems
• ✓Documentation of withdrawal symptoms (tremor, diaphoresis, tachycardia, hypertension, anxiety, nausea, seizures) occurring after reduction or cessation of alcohol use
• ✓Documentation of delirium tremens: severe confusion, agitation, hallucinations, autonomic instability, fever — a medical emergency requiring ICU-level care
• ✓Assessment and plan addressing alcohol use disorder with treatment recommendations (counseling, medication-assisted treatment, referral, etc.)

Commonly Confused Codes