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

ICD-10 F11.29

Billable / Specific HCC v28: 55

Opioid dependence with unspecified opioid-induced disorder

F11
Block
0
Synonyms
299
LCDs
15
Payer Policies
88
Linked CPTs

About ICD-10-CM F11.29

ICD-10-CM code F11.29 represents Opioid dependence with unspecified opioid-induced disorder. This is a billable/specific code in the Mental, Behavioral, and Neurodevelopmental chapter (block F11). The 2026 edition of ICD-10-CM F11.29 became effective on October 1, 2025.

Coding Tips for F11.29

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

HCC capture: document with MEAT each year

F11.29 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

CMS-HCC v28 (current)
Category 55
ESRD-HCC
Category 55
RxHCC (Part D)
Category 55

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 F11.29

Local Coverage Determinations (LCDs) from CMS MACs that list F11.29 as a covered diagnosis.

299 LCDs

Showing top 10 of 299 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Urine Drug Testing
Article ID: 59416, Effective: 2025-11-01 00:00:00, 428 covered, 0 non-covered
CPT G0480 →
CMS LCD: Billing and Coding: Urine Drug Testing
Article ID: 59416, Effective: 2025-11-01 00:00:00, 428 covered, 0 non-covered
CPT G0481 →
CMS LCD: Billing and Coding: Urine Drug Testing
Article ID: 59416, Effective: 2025-11-01 00:00:00, 428 covered, 0 non-covered
CPT G0482 →
CMS LCD: Billing and Coding: Urine Drug Testing
Article ID: 59416, Effective: 2025-11-01 00:00:00, 428 covered, 0 non-covered
CPT G0483 →
CMS LCD: Billing and Coding: Urine Drug Testing
Article ID: 59416, Effective: 2025-11-01 00:00:00, 428 covered, 0 non-covered
CPT 80305 →
CMS LCD: Billing and Coding: Urine Drug Testing
Article ID: 59416, Effective: 2025-11-01 00:00:00, 428 covered, 0 non-covered
CPT G0659 →
CMS LCD: Billing and Coding: Urine Drug Testing
Article ID: 59416, Effective: 2025-11-01 00:00:00, 428 covered, 0 non-covered
CPT 80307 →
CMS LCD: Billing and Coding: Urine Drug Testing
Article ID: 59416, Effective: 2025-11-01 00:00:00, 428 covered, 0 non-covered
CPT 80306 →
CMS LCD: Billing and Coding: Urine Drug Testing
Article ID: 55001, Effective: 2026-01-01 00:00:00, 388 covered, 0 non-covered
CPT G0480 →
CMS LCD: Billing and Coding: Urine Drug Testing
Article ID: 55001, Effective: 2026-01-01 00:00:00, 388 covered, 0 non-covered
CPT G0481 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing F11.29.

15 policies

5 Medicare

Billing and Coding: Urine Drug Testing
Policy ID: ART-54799
Billing and Coding: Urine Drug Testing
Policy ID: ART-55001
Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
Policy ID: ART-56645
Billing and Coding: Home Health - Psychiatric Care
Policy ID: ART-56756
Billing and Coding: Urine Drug Testing
Policy ID: ART-56818

CPT Codes Commonly Billed with F11.29

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

88 linkages
  • 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 F11.29 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
F11.29 2929 10111
F11.29 30400 10112

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 F11.29, Billing FAQ

Is ICD-10 code F11.29 billable? +

Yes, F11.29 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Does F11.29 affect Medicare Advantage HCC risk adjustment? +

Yes. F11.29 maps to CMS-HCC v28 category 55. Capture this diagnosis annually for accurate Medicare Advantage risk score.

What CPT codes are commonly billed with F11.29? +

Procedures frequently paired with F11.29 include: G0480, 80306, G0482, 0603U, 80305.

What ICD-9 codes does F11.29 map to? +

Per CMS GEMs, F11.29 maps to ICD-9 codes: 2929, 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 July 16, 2026.

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