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

ICD-10 F11.90

Billable / Specific

Opioid use, unspecified, uncomplicated

F11
Block
0
Synonyms
251
LCDs
11
Payer Policies
20
Linked CPTs

About ICD-10-CM F11.90

ICD-10-CM code F11.90 represents Opioid use, unspecified, uncomplicated. This is a billable/specific code in the Mental, Behavioral, and Neurodevelopmental chapter (block F11). The 2026 edition of ICD-10-CM F11.90 became effective on October 1, 2025.

Medicare LCD Coverage for F11.90

Local Coverage Determinations (LCDs) from CMS MACs that list F11.90 as a covered diagnosis.

251 LCDs

Showing top 10 of 251 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
Article ID: 56645, Effective: 2024-10-01 00:00:00, 1310 covered, 1 non-covered
CPT G0480 →
CMS LCD: Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
Article ID: 56645, Effective: 2024-10-01 00:00:00, 1310 covered, 1 non-covered
CPT G0481 →
CMS LCD: Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
Article ID: 56645, Effective: 2024-10-01 00:00:00, 1310 covered, 1 non-covered
CPT G0482 →
CMS LCD: Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
Article ID: 56645, Effective: 2024-10-01 00:00:00, 1310 covered, 1 non-covered
CPT G0483 →
CMS LCD: Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
Article ID: 56645, Effective: 2024-10-01 00:00:00, 1310 covered, 1 non-covered
CPT 80305 →
CMS LCD: Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
Article ID: 56645, Effective: 2024-10-01 00:00:00, 1310 covered, 1 non-covered
CPT G0659 →
CMS LCD: Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
Article ID: 56645, Effective: 2024-10-01 00:00:00, 1310 covered, 1 non-covered
CPT 80307 →
CMS LCD: Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
Article ID: 56645, Effective: 2024-10-01 00:00:00, 1310 covered, 1 non-covered
CPT 80306 →
CMS LCD: Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services
Article ID: 57520, Effective: 2025-01-01 00:00:00, 582 covered, 1 non-covered
CPT 90847 →
CMS LCD: Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services
Article ID: 57520, Effective: 2025-01-01 00:00:00, 582 covered, 1 non-covered
CPT G0560 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing F11.90.

11 policies

5 Medicare

Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
Policy ID: ART-56645
Billing and Coding: Urine Drug Testing
Policy ID: ART-56818
Billing and Coding: Psychiatry and Psychology Services
Policy ID: ART-56937
Billing and Coding: Outpatient Psychiatry and Psychology Services
Policy ID: ART-57065
Billing and Coding: Psychiatric Codes
Policy ID: ART-57130

1 Aetna

Tuberculosis Testing
Policy ID: CPB-0471

CPT Codes Commonly Billed with F11.90

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

20 linkages
  • G2215 CMS LCD: Billing and Coding: Opioid Treatment Programs CMS LCD
  • G2073 CMS LCD: Billing and Coding: Opioid Treatment Programs CMS LCD
  • G2067 CMS LCD: Billing and Coding: Opioid Treatment Programs CMS LCD
  • G2079 CMS LCD: Billing and Coding: Opioid Treatment Programs CMS LCD
  • G0137 CMS LCD: Billing and Coding: Opioid Treatment Programs CMS LCD
  • G2080 CMS LCD: Billing and Coding: Opioid Treatment Programs CMS LCD
  • G2075 CMS LCD: Billing and Coding: Opioid Treatment Programs CMS LCD
  • G2068 CMS LCD: Billing and Coding: Opioid Treatment Programs CMS LCD
  • G2074 CMS LCD: Billing and Coding: Opioid Treatment Programs CMS LCD
  • G0534 CMS LCD: Billing and Coding: Opioid Treatment Programs CMS LCD

Convert F11.90 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
F11.90 30550 10000

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

ICD-10 F11.90, Billing FAQ

Is ICD-10 code F11.90 billable? +

Yes, F11.90 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What CPT codes are commonly billed with F11.90? +

Procedures frequently paired with F11.90 include: G2215, G2073, G2067, G2079, G0137.

What ICD-9 codes does F11.90 map to? +

Per CMS GEMs, F11.90 maps to ICD-9 codes: 30550. 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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