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F11.11

Billable

Opioid abuse, in remission

HCC Category Mapping

V28HCC 138Drug Use Disorder/Substance Use Disorder, Mild
0.476
V24HCC 56Drug/Alcohol Abuse, Without Dependence
0.000
ESRDHCC 56Drug/Alcohol Abuse, Without Dependence
0.000

What This Code Means

A person previously abused opioids but is now in remission, meaning they have stopped or significantly reduced their opioid use.

Coding Tips

  • Use this code when documentation clearly states the patient is in remission or recovery from opioid abuse
  • Specify the length of remission (early or sustained) if documented; this may require a fifth character in some contexts

Clinical Significance

Opioid abuse in remission indicates a patient has a history of opioid abuse but is currently in recovery. This diagnosis is important for ongoing risk stratification and monitoring, as patients in remission remain at risk for relapse. Documenting remission status reflects positive clinical outcomes while maintaining awareness of the substance use history.

Documentation Requirements

  • Provider documentation of prior opioid abuse
  • Statement that the patient is currently in remission
  • Duration of remission if documented (early vs. sustained)
  • Current treatment status (medication-assisted treatment, counseling, support programs)
  • Assessment of relapse risk factors
  • Documentation of any ongoing monitoring or recovery program participation

Commonly Confused Codes

Code Hierarchy

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