Opioid abuse, uncomplicated

This code signifies a pattern of problematic opioid use leading to clinically significant impairment or distress, without the presence of physiological dependence or withdrawal symptoms. It indicates an individual is misusing opioids but has not yet developed addiction with physical manifestations.

This code is appropriate when documentation clearly indicates opioid abuse without mention of dependence, tolerance, or withdrawal. It is supported by a diagnosis of opioid abuse based on DSM-5 criteria, such as continued use despite negative consequences, but lacking evidence of a substance use disorder with physiological dependence.

• Do not use this code if documentation indicates opioid dependence or withdrawal; instead, refer to codes for opioid dependence.
• Ensure the documentation explicitly states "abuse" and not "dependence" or "addiction" for accurate code assignment.
• This code should be sequenced as a primary diagnosis when the opioid abuse is the reason for the encounter, or as a secondary diagnosis if it's a co-morbidity.