F13.131
BillableSedative, hypnotic or anxiolytic abuse with withdrawal delirium
HCC Category Mapping
V28HCC 135 — Drug/Alcohol Psychosis
0.000V24HCC 54 — Drug/Alcohol Psychosis
0.434ESRDHCC 54 — Drug/Alcohol Psychosis
0.000What This Code Means
A person misuses sedatives, sleeping pills, or anti-anxiety medications and is experiencing withdrawal with severe confusion, disorientation, and altered consciousness (delirium).
Coding Tips
- •Withdrawal delirium is a medical emergency requiring close monitoring and possible hospitalization
- •Document onset of delirium relative to last use and any autonomic symptoms (fever, tachycardia, hypertension)
Clinical Significance
Sedative, hypnotic, or anxiolytic abuse with withdrawal delirium is a medical emergency. Withdrawal delirium from sedatives (similar to delirium tremens from alcohol) involves severe confusion, autonomic instability, agitation, and can be fatal without treatment. This condition typically requires intensive care unit admission and aggressive pharmacological management. The code captures the highest level of withdrawal severity and maps to the highest substance use HCC category.
Documentation Requirements
- ✓Documentation of sedative/hypnotic/anxiolytic abuse
- ✓Acute delirium findings: severe confusion, disorientation, altered consciousness, agitation
- ✓Autonomic instability: fever, tachycardia, hypertension, diaphoresis
- ✓Temporal relationship to cessation or reduction of sedative use
- ✓Monitoring records (vital signs, neurological checks, sedation scales)
- ✓Treatment documentation (benzodiazepine taper, supportive care, ICU monitoring)
- ✓Exclusion of other causes of delirium
Commonly Confused Codes
F13.130 — Sedative abuse with withdrawal, uncomplicated; use when no delirium is presentF13.132 — Sedative abuse with withdrawal with perceptual disturbance; use when hallucinations occur without full deliriumF13.121 — Sedative abuse with intoxication delirium; different — this is intoxication-related, not withdrawal-relatedF13.231 — Sedative dependence with withdrawal delirium; use when dependence is documented
Code Hierarchy
└F13Sedative, hypnotic, or anxiolytic related disorders└F13.1Sedative, hypnotic or anxiolytic-related abuse└F13.13Sedative, hypnotic or anxiolytic abuse with withdrawal└F13.131Sedative, hypnotic or anxiolytic abuse with withdrawal delirium
└F13.131Sedative, hypnotic or anxiolytic abuse with withdrawal delirium