ICD-10 F11.220
Billable / Specific HCC v28: 55Opioid dependence with intoxication, uncomplicated
About ICD-10-CM F11.220
ICD-10-CM code F11.220 represents Opioid dependence with intoxication, uncomplicated. This is a billable/specific code in the Mental, Behavioral, and Neurodevelopmental chapter (block F11). The 2026 edition of ICD-10-CM F11.220 became effective on October 1, 2025.
Coding Tips for F11.220
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
F11.220 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.
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 F11.220
Local Coverage Determinations (LCDs) from CMS MACs that list F11.220 as a covered diagnosis.
Showing top 10 of 348 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing F11.220.
5 Medicare
CPT Codes Commonly Billed with F11.220
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- G0480 CMS LCD: Billing and Coding: Urine Drug Testing CMS LCD
- 80306 CMS LCD: Billing and Coding: Urine Drug Testing CMS LCD
- G0482 CMS LCD: Billing and Coding: Urine Drug Testing CMS LCD
- 0603U CMS LCD: Billing and Coding: Urine Drug Testing CMS LCD
- 80305 CMS LCD: Billing and Coding: Urine Drug Testing CMS LCD
- G0659 CMS LCD: Billing and Coding: Urine Drug Testing CMS LCD
- G0483 CMS LCD: Billing and Coding: Urine Drug Testing CMS LCD
- 80307 CMS LCD: Billing and Coding: Urine Drug Testing CMS LCD
- G0481 CMS LCD: Billing and Coding: Urine Drug Testing CMS LCD
- G2215 CMS LCD: Billing and Coding: Opioid Treatment Programs CMS LCD
Convert F11.220 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 |
|---|---|---|
| F11.220 | 2922 | 10111 |
| F11.220 | 30400 | 10112 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To F11.220
Other codes in section F10-F19 (Mental and behavioral disorders due to psychoactive substance use).
ICD-10 F11.220, Billing FAQ
Is ICD-10 code F11.220 billable? +
Yes, F11.220 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Does F11.220 affect Medicare Advantage HCC risk adjustment? +
Yes. F11.220 maps to CMS-HCC v28 category 55. Capture this diagnosis annually for accurate Medicare Advantage risk score.
What CPT codes are commonly billed with F11.220? +
Procedures frequently paired with F11.220 include: G0480, 80306, G0482, 0603U, 80305.
What ICD-9 codes does F11.220 map to? +
Per CMS GEMs, F11.220 maps to ICD-9 codes: 2922, 30400. 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 May 31, 2026.
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