F11.921

Billable

Opioid use, unspecified with intoxication delirium

HCC Category Mapping

V28HCC 137 — Drug Use Disorder/Substance Use Disorder, Moderate/Severe

0.358

V24HCC 55 — Drug/Alcohol Dependence

0.334

ESRDHCC 55 — Drug/Alcohol Dependence

0.000

What This Code Means

A state of confusion and disorientation caused by opioid intoxication, where the person is unaware of their surroundings and may experience hallucinations or delirium.

Coding Tips

•This code requires documentation of both opioid use and delirium symptoms during intoxication
•Distinguish from F11.922 which involves perceptual disturbances without full delirium

Clinical Significance

Opioid use, unspecified with intoxication delirium is a medical emergency involving acute confusion and altered consciousness from opioid intoxication in a patient whose use pattern is not classified. This may present as obtundation, stupor, or coma and carries high mortality risk from respiratory depression. Immediate intervention including naloxone may be required.

Documentation Requirements

✓Documentation of opioid intoxication
✓Delirium symptoms documented (acute confusion, disorientation, altered consciousness, fluctuating mental status)
✓Vital signs including respiratory rate and oxygen saturation
✓Glasgow Coma Scale or other consciousness assessment
✓Naloxone administration and response if applicable
✓Toxicology screen results
✓Emergency treatment documentation

Commonly Confused Codes

F11.920 — Opioid use, unspecified with intoxication, uncomplicated: use when intoxication is present WITHOUT delirium F11.922 — Opioid use, unspecified with intoxication with perceptual disturbance: use for perceptual changes without delirium F11.121 — Opioid abuse with intoxication delirium: use when abuse is documented F11.221 — Opioid dependence with intoxication delirium: use when dependence is documented

Code Hierarchy

└F11.921Opioid use, unspecified with intoxication delirium