F11.93

Billable

Opioid use, unspecified with withdrawal

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

Physical and psychological symptoms that occur when someone stops using opioids after prolonged use, including anxiety, body aches, and cravings.

Coding Tips

•Document withdrawal symptoms such as sweating, tremors, insomnia, or muscle aches
•Distinguish from intoxication codes; withdrawal occurs during abstinence or reduction of opioid use

Clinical Significance

Opioid use, unspecified with withdrawal captures opioid withdrawal symptoms in a patient whose use pattern is not classified as abuse or dependence. Opioid withdrawal causes significant distress including muscle pain, gastrointestinal symptoms, anxiety, and insomnia. This code is used when documentation confirms withdrawal but does not specify the severity of the underlying use disorder.

Documentation Requirements

✓Documentation of opioid withdrawal symptoms (myalgia, rhinorrhea, lacrimation, diaphoresis, piloerection, nausea, diarrhea, insomnia, anxiety)
✓Statement that opioid use pattern is not specified
✓Clinical Opiate Withdrawal Scale (COWS) score if available
✓Temporal relationship between opioid reduction/cessation and symptoms
✓Treatment plan for withdrawal management

Excludes 1 — Do NOT code together

opioid use, unspecified with intoxication (F11.92-)

Commonly Confused Codes

F11.13 — Opioid abuse with withdrawal: use when abuse is documented F11.23 — Opioid dependence with withdrawal: use when dependence is documented F11.920 — Opioid use, unspecified with intoxication: withdrawal and intoxication are clinically opposite T40.2X1A — Poisoning by other opioids: poisoning codes are for overdose, not withdrawal

Code Hierarchy

└F11.93Opioid use, unspecified with withdrawal