ICD-10 F11.14
Billable / Specific HCC v28: 55Opioid abuse with opioid-induced mood disorder
About ICD-10-CM F11.14
ICD-10-CM code F11.14 represents Opioid abuse with opioid-induced mood disorder. This is a billable/specific code in the Mental, Behavioral, and Neurodevelopmental chapter (block F11). The 2026 edition of ICD-10-CM F11.14 became effective on October 1, 2025.
Coding Tips for F11.14
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
F11.14 is a CMS-HCC v28 risk-adjustment code (category 55). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under F11.14. Per CMS ICD-10-CM Tabular 2026.
- Opioid use disorder, mild, with opioid-induced depressive disorder
Medicare Advantage HCC Impact
Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.
Medicare LCD Coverage for F11.14
Local Coverage Determinations (LCDs) from CMS MACs that list F11.14 as a covered diagnosis.
Showing top 10 of 380 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing F11.14.
1 Cigna
5 Medicare
CPT Codes Commonly Billed with F11.14
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 96121 CMS LCD: Billing and Coding: Psychiatric Partial Hospitalization Programs CMS LCD
- 96137 CMS LCD: Billing and Coding: Psychiatric Partial Hospitalization Programs CMS LCD
- 96116 CMS LCD: Billing and Coding: Psychiatric Partial Hospitalization Programs CMS LCD
- 96132 CMS LCD: Billing and Coding: Psychiatric Partial Hospitalization Programs CMS LCD
- 90838 CMS LCD: Billing and Coding: Psychiatric Partial Hospitalization Programs CMS LCD
- G0177 CMS LCD: Billing and Coding: Psychiatric Partial Hospitalization Programs CMS LCD
- 96146 CMS LCD: Billing and Coding: Psychiatric Partial Hospitalization Programs CMS LCD
- 90846 CMS LCD: Billing and Coding: Psychiatric Partial Hospitalization Programs CMS LCD
- G0411 CMS LCD: Billing and Coding: Psychiatric Partial Hospitalization Programs CMS LCD
- 96112 CMS LCD: Billing and Coding: Psychiatric Partial Hospitalization Programs CMS LCD
Convert F11.14 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| F11.14 | 29284 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To F11.14
Other codes in section F10-F19 (Mental and behavioral disorders due to psychoactive substance use).
ICD-10 F11.14, Billing FAQ
Is ICD-10 code F11.14 billable? +
Yes, F11.14 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What other names or terms map to F11.14? +
ICD-10 F11.14 includes: Opioid use disorder, mild, with opioid-induced depressive disorder.
Does F11.14 affect Medicare Advantage HCC risk adjustment? +
Yes. F11.14 maps to CMS-HCC v28 category 55. Capture this diagnosis annually for accurate Medicare Advantage risk score.
What CPT codes are commonly billed with F11.14? +
Procedures frequently paired with F11.14 include: 96121, 96137, 96116, 96132, 90838.
What ICD-9 codes does F11.14 map to? +
Per CMS GEMs, F11.14 maps to ICD-9 codes: 29284. Useful for legacy data review and historical claim analysis.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on July 16, 2026.
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