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F11 ICD-10-CM Code: Opioid related disorders

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Billing Status: NO. This is a non-billable ICD-10-CM code: report a more specific billable code beneath it.

Category · FY2027A non-billable heading in the tabular list: report a more specific code beneath it.

What you need to know

Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too, and is marked with where it comes from.

The tabular list publishes no instructional note for this code itself.

Where it sits Source: CMS/NCHS

Under:Chapter 5: Mental, Behavioral and Neurodevelopmental DisordersF10-F19 Mental and behavioral disorders due to psychoactive substance use

Codes under F11 (3)

  • F11.1Opioid abuseNot billable
  • F11.2Opioid dependenceNot billable
  • F11.9Opioid use, unspecifiedNot billable

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Coder workflow for F11

MedCoder structured workflow — derived from this code’s own official record

Before you code F11

  1. F11 is not reportable as written. Select the more specific code beneath it that the documentation supports. Codes are reported to the highest level of specificity the classification provides (Guidelines I.B.2).

    ReviewF11.1, F11.2, F11.9

    See the relationships section · Guide: How to choose an ICD-10-CM code →

Choose the right path

  1. Does the documentation support one of the more specific codes beneath F11?
    Yes → Select that code and continue the checks below on its own page.
    No → F11 cannot be reported as written. Where the codes beneath it include an unspecified code, that code applies when the record goes no further; otherwise query for the missing detail.

    ReviewF11.1, F11.2, F11.9

Report the code beneath F11 that the documentation supports, not F11 itself. Then confirm that code is valid for the date of service on its own page.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Coding context

Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.

Code Overview

Opioid related disorders is a non-billable ICD-10-CM category code (F11). A more specific billable subcode must be selected for claims submission.

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Official Coding Guidelines

Official source data — quoted verbatim from the CMS/NCHS Official Guidelines

Verbatim excerpts from the ICD-10-CM Official Guidelines for Coding and Reporting (CMS/NCHS) that govern this code.

Chapter 15: Pregnancy, Childbirth, and the Puerperium (O00-O9A)

3) Drug use during pregnancy, childbirth and the puerperium Codes under subcategory O99.32, Drug use complicating pregnancy, childbirth, and the puerperium, should be assigned for any pregnancy case when a patient uses drugs during the pregnancy or postpartum. This can involve illegal drugs, or inappropriate use or abuse of prescription drugs. Secondary code(s) from categories F11-F16 and F18-F19 should also be assigned to identify manifestations of the drug use.

Verify Before Coding

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder-derived relationships — computed from published CMS and AHRQ datasets

Other codes that name F11 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 2 Excludes1 notes: R41.3 — Other amnesia, R44 — Other symptoms and signs involving general sensations and perceptions.

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

Referenced by 33 Excludes2 notes across 4 chapters: F02 — Dementia in other diseases classified elsewhere, F06 — Other mental disorders due to known physiological condition, F06.0 — Psychotic disorder with hallucinations due to known physiological condition, F06.2 — Psychotic disorder with delusions due to known physiological condition, F06.3 — Mood disorder due to known physiological condition, F06.4 — Anxiety disorder due to known physiological condition, F20 — Schizophrenia, F55 — Abuse of non-psychoactive substances, F63 — Impulse disorders, F63.1 — Pyromania, R78 — Findings of drugs and other substances, not normally found in blood, T36 — Poisoning by, adverse effect of and underdosing of systemic antibiotics, T36-T39 — Antibiotics & Anti-infectives (T36-T39), T36-T50 — Poisoning by, adverse effects of and underdosing of drugs, medicaments and biological substances (T36-T50), T37 — Poisoning by, adverse effect of and underdosing of other systemic anti-infectives and antiparasitics, T38 — Poisoning by, adverse effect of and underdosing of hormones and their synthetic substitutes and antagonists, not elsewhere classified, T39 — Poisoning by, adverse effect of and underdosing of nonopioid analgesics, antipyretics and antirheumatics, T40 — Poisoning by, adverse effect of and underdosing of narcotics and psychodysleptics [hallucinogens], T40-T41 — Analgesics & Antipyretics (T40-T41), T41 — Poisoning by, adverse effect of and underdosing of anesthetics and therapeutic gases, +13 more.

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

Referenced by 3 Use Additional Code instructions across 3 chapters: K85.3 — Drug induced acute pancreatitis, O99.32 — Drug use complicating pregnancy, childbirth, and the puerperium, Z71.5 — Drug abuse counseling and surveillance.

These codes instruct coders to additionally report this code when it applies.

Contextual Map

Every relationship of F11 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run F11 with these 13 related codes in Claim Check

Hierarchy

Referenced by Excludes1 notes

Referenced by Excludes2 notes (33)

Referenced by Use Additional Code instructions

Nearest codes (57)

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Reference

Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.

Common coding questions

MedCoder editorial

Can F11 be billed directly?

No. F11 (Opioid related disorders) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Coding guidelines Official source data
ICD-10-CM Official Guidelines for Coding and Reporting (FY2027), quoted by section Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 2026) Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder-derived relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder editorial explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources

Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "F11 — Opioid related disorders." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/f11-opioid-related-disorders

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Opioid related disorders

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to F11 in its code family, with their registry titles.