Wiki Alcohol abuse/anxiety disorder

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B
Code: F10.180
Alcohol abuse with alcohol-induced anxiety disorder
Parent Code Notes: F10.1
Excludes1: alcohol dependence (F10.2-)
alcohol use, unspecified (F10.9-)
Parent Code Notes: F10
Use additional code for blood alcohol level, if applicable (Y90.-)

Block Notes
Mental and behavioral disorders due to psychoactive substance use (F10-F19)

Coding Guidelines
Mental, Behavioral and Neurodevelopmental disorders (F01-F99)
Includes: disorders of psychological development
Excludes 2: symptoms, signs and abnormal clinical laboratory findings, not elsewhere classified (R00-R99)

ancoleman22

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I have a case where the patient has alcohol abuse, PTSD, anxiety disorder, among others.

My question is, would I link the alcohol abuse with these conditions such as anxiety disorder? They are not linked anywhere in the documentation but by the new guidelines of "with" they would be linked.

Thanks!
 
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I have a case where the patient has alcohol abuse, PTSD, anxiety disorder, among others.

My question is, would I link the alcohol abuse with these conditions such as anxiety disorder? They are not linked anywhere in the documentation but by the new guidelines of "with" they would be linked.

Thanks!

The alcohol abuse would only be linked if it was documented as the cause of the disorder.

For example, if you look under Abuse>Alcohol (non-dependent)>with>anxiety disorder, it sends you to F10.180. The description for that code is "Alcohol abuse with alcohol-induced anxiety disorder".
 

ancoleman22

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So unless it is documentation together, we do not link these? The new guidelines of "with" are throwing me off on this one. I don't want to link these, as they aren't linked in the documentation. But...the new guidelines of "with" are telling me that they should be linked because they are linked in the alpha index with "with".

Example:
Abuse>Alcohol (non-dependent)>"with">anxiety disorder

Just like...

Diabetes>type 2>"with">chronic kidney disease
 
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No one likes the "with" mess :rolleyes:

When it comes to DM and CKD, "with" indicates there is a presumed causal relationship. The thought process for this guideline is that, more often than not, if a patient has both DM and CKD, they are related to one another. It's kind of like using DM2 as a default when the type is unknown. This is because MOST people have type 2.

But in your case, it would be incorrect to apply that logic. That would be like saying that, more often than not, if a patient is diagnosed with alcohol abuse and has anxiety, those conditions are related.

More importantly, when you follow the look-up in the index and get your code, you need to ask yourself if the code descriptor is accurate to your situation. So for Abuse>Alcohol (non-dependent)>with>anxiety disorder, you're directed to F10.180. The descriptor for F10.180 states "Alcohol abuse with alcohol-induced anxiety disorder". Did the provider document that the alcohol abuse created, or was the cause of, the anxiety disorder? If so, then F10.180 would be correct. If not, then F10.180 would not be correct and each condition would be coded separately.

For PTSD, thinking logically about it, it would be very unlikely that alcohol abuse would induce PTSD. It certainly wouldn't help things, but it would be more likely that the patient is self-medicating with alcohol to treat the PTSD symptoms.

Just skimming through the codes under Abuse>Alcohol (non-dependent)>with>, every code listed has "alcohol-induced" in the descriptor. That would be the key factor here.
F10.14 Alcohol abuse with alcohol-induced mood disorder
F10.159 Alcohol abuse with alcohol-induced psychotic disorder, unspecified
F10.182 Alcohol abuse with alcohol-induced sleep disorder
 
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