F11.221
BillableOpioid dependence with intoxication delirium
HCC Category Mapping
V28HCC 137 — Drug Use Disorder/Substance Use Disorder, Moderate/Severe
0.358V24HCC 55 — Drug/Alcohol Dependence
0.334ESRDHCC 55 — Drug/Alcohol Dependence
0.000What This Code Means
A person who is dependent on opioids and is currently intoxicated with delirium, a serious condition involving confusion, disorientation, and altered mental status caused by the opioid intoxication.
Coding Tips
- •Document specific delirium symptoms such as confusion, disorientation, hallucinations, or agitation
- •This is a more severe presentation than uncomplicated intoxication and may require emergency intervention
Clinical Significance
Opioid dependence with intoxication delirium is a medical emergency representing acute confusion and altered consciousness during opioid intoxication in a dependent patient. This may indicate overdose requiring emergency intervention including naloxone. It carries significant morbidity and mortality risk and reflects the highest acuity within opioid intoxication presentations.
Documentation Requirements
- ✓Provider documentation of opioid dependence
- ✓Documentation of active intoxication
- ✓Delirium symptoms documented (acute confusion, disorientation, fluctuating consciousness)
- ✓Vital signs including respiratory rate, oxygen saturation, and hemodynamic status
- ✓Naloxone administration if applicable
- ✓Toxicology screen results
- ✓Glasgow Coma Scale or other consciousness assessment
- ✓Emergency treatment and monitoring plan
Commonly Confused Codes
F11.220 — Opioid dependence with intoxication, uncomplicated: use when intoxication is present WITHOUT deliriumF11.222 — Opioid dependence with intoxication with perceptual disturbance: use for perceptual changes without global confusionF11.121 — Opioid abuse with intoxication delirium: use when abuse (not dependence) is documentedT40.2X1A — Poisoning by other opioids, accidental, initial encounter: use for overdose/poisoning events
Code Hierarchy
└F11Opioid related disorders└F11.2Opioid dependence└F11.22Opioid dependence with intoxication└F11.221Opioid dependence with intoxication delirium
└F11.221Opioid dependence with intoxication delirium