ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 F11

Non-Billable Header

Opioid related disorders

F11
Block
0
Synonyms
0
LCDs
1
Payer Policies
1
Linked CPTs

About ICD-10-CM F11

ICD-10-CM code F11 represents Opioid related disorders. This is a non-billable header code in the Mental, Behavioral, and Neurodevelopmental chapter (block F11). The 2026 edition of ICD-10-CM F11 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.

Medicare LCD Coverage for F11

Local Coverage Determinations (LCDs) from CMS MACs that list F11 as a covered diagnosis.

No Medicare LCDs reference F11 as covered

This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.

Commercial Payer Coverage

Coverage policies from major commercial payers referencing F11.

1 policies

1 Aetna

Oxygen - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0002

CPT Codes Commonly Billed with F11

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

1 linkages
  • 90791 Psychiatric diagnostic interview for substance abuse Internal Medicine

ICD-10 F11, Billing FAQ

Is ICD-10 code F11 billable? +

No, F11 is a non-billable header code. Use a more specific child code from block F11 when submitting claims.

What CPT codes are commonly billed with F11? +

Procedures frequently paired with F11 include: 90791.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on May 31, 2026.

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