Wiki Steroid Withdrawal ICD-10

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C
Code: F19.230
Other psychoactive substance dependence with withdrawal, uncomplicated
Parent Code Notes: F19.23
Excludes1: other psychoactive substance dependence with intoxication (F19.22-)
Parent Code Notes: F19.2
Excludes1: other psychoactive substance abuse (F19.1-)
other psychoactive substance use, unspecified (F19.9-)
Parent Code Notes: F19
Includes: polysubstance drug use (indiscriminate drug use)

Category 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)

eortega

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Hi everyone,

I'm looking for a diagnosis code for "Steroid Withdrawal". Initially, I came up with ICD-10 F19.230; but after researching online, I found that "All of these drugs (Narcotics, Depressants, Stimulants and Hallucinogens), with the exception of anabolic steroids, are considered to be psychoactive – meaning they affect one or more of the mental faculties including mood, feelings, thoughts, perception, memory, cognition, and behavior." https://luxury.rehabs.com/drug-abuse/classifications/. According to this source, Anabolic Steroids are Non-psychoactive substances.

Another source cite Anabolic Steroids as a separate drug class: "The Controlled Substances Act (CSA) regulates five classes of drugs: narcotics, depressants, stimulants, hallucinogens, and anabolic steroids." https://www.dea.gov/druginfo/concern_dextro.shtml

The only code I found for abuse of other non-psychoactive substances is F55.8, but there's no withdrawal stage. Has anyone of you come across "steroid withdrawal" diagnosis?
 

Manas maity

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Generally an anabolic steroids have more withdrawal symptoms which can sometimes lead to depression. But for the rest other steroids the withdrawal effect is less and they donot cause any habit foming behaviour.
Now since there is'nt any code for such steroid withdrawl condition. So i would prefer to code symptoms of steroid withdrawal only.
 

ckeeney

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DSM-5 states "For substances that do not fit into any of the classes (e.g., anabolic steroids), the appropriate code for “other substance use disorder” should be used and the specific substance indicated (e.g., 305.90 [F19.10] mild anabolic steroid use disorder). " and further on it states "The ICD-10-CM code for other (or unknown) substance withdrawal is F19.239. Note that the ICD-10-CM code indicates the comorbid presence of a moderate or severe other (or unknown) substance use disorder. It is not permissible to code a comorbid mild other (or unknown) substance use disorder with other (or unknown) substance withdrawal." You may need to query the provider on severity of use that is the determinant in DSM-5 between use (mild) and dependence (moderate or severe) for coding in ICD-10-CM.
 

eortega

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Generally an anabolic steroids have more withdrawal symptoms which can sometimes lead to depression. But for the rest other steroids the withdrawal effect is less and they donot cause any habit foming behaviour.
Now since there is'nt any code for such steroid withdrawl condition. So i would prefer to code symptoms of steroid withdrawal only.

Thank you, Manas maity.

This seems to be the best temporary solution for when we don't have a specific ICD-10 code to describe "Steroid Withdrawal" diagnosis. My intent with bringing this issue is to have AMA take a look and create a diagnosis code in the near future. Hopefully we can get their attention.
 

eortega

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DSM-5 states "For substances that do not fit into any of the classes (e.g., anabolic steroids), the appropriate code for “other substance use disorder” should be used and the specific substance indicated (e.g., 305.90 [F19.10] mild anabolic steroid use disorder). " and further on it states "The ICD-10-CM code for other (or unknown) substance withdrawal is F19.239. Note that the ICD-10-CM code indicates the comorbid presence of a moderate or severe other (or unknown) substance use disorder. It is not permissible to code a comorbid mild other (or unknown) substance use disorder with other (or unknown) substance withdrawal." You may need to query the provider on severity of use that is the determinant in DSM-5 between use (mild) and dependence (moderate or severe) for coding in ICD-10-CM.

Ckeeney,

Thank you so much for providing the DSM-5 guideline above; however, ICD-10 code F19.239 description Other psychoactive substance dependence with withdrawal, unspecified , contradicts the anabolic steroids drug classification (non-psychoactive substance). No Provider query is necessary in this case since "withdrawal" stage is supported by documentation; therefore, (mild) or (moderate or severe) does not apply.
 
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