ICD-10 F11.282
Billable / Specific HCC v28: 55 CCOpioid dependence with opioid-induced sleep disorder
About ICD-10-CM F11.282
ICD-10-CM code F11.282 represents Opioid dependence with opioid-induced sleep disorder. This is a billable/specific code in the Mental, Behavioral, and Neurodevelopmental chapter (block F11). The 2026 edition of ICD-10-CM F11.282 became effective on October 1, 2025.
Coding Tips for F11.282
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
F11.282 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.
F11.282 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.
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.
Inpatient DRG Impact, CC
codes Opioid dependence with opioid-induced sleep disorder. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for F11.282
Local Coverage Determinations (LCDs) from CMS MACs that list F11.282 as a covered diagnosis.
Showing top 10 of 351 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing F11.282.
5 Medicare
1 Aetna
CPT Codes Commonly Billed with F11.282
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 F11.282 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 |
|---|---|---|
| F11.282 | 29285 | 10111 |
| F11.282 | 30400 | 10112 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To F11.282
Other codes in section F10-F19 (Mental and behavioral disorders due to psychoactive substance use).
ICD-10 F11.282, Billing FAQ
Is ICD-10 code F11.282 billable? +
Yes, F11.282 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Does F11.282 affect Medicare Advantage HCC risk adjustment? +
Yes. F11.282 maps to CMS-HCC v28 category 55. Capture this diagnosis annually for accurate Medicare Advantage risk score.
Is F11.282 a CC or MCC for inpatient DRG? +
Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.
What CPT codes are commonly billed with F11.282? +
Procedures frequently paired with F11.282 include: G0480, 80306, G0482, 0603U, 80305.
What ICD-9 codes does F11.282 map to? +
Per CMS GEMs, F11.282 maps to ICD-9 codes: 29285, 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 June 1, 2026.
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