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F10–F19 — how ICD-10 substance use codes are built

F12.20 is cannabis dependence, uncomplicated — and every substance code in ICD-10-CM is built the same way, so the pattern is worth learning once rather than looking up ten times. The third character is the substance, the fourth is abuse, dependence or use, and what follows describes any complication. The rule that causes most denials sits at the fourth character: abuse, dependence and use are mutually exclusive for the same substance and can never appear together on a claim. Below: the pattern, the substance list and the CPT pairings.

This page is billing and administrative reference. It describes what a code means and whether it can be submitted. It is not clinical advice and does not tell anyone what to diagnose.

The ten substance families

CodeTitleBillable?
F10Alcohol related disordersNo
F11Opioid related disordersNo
F12Cannabis related disordersNo
F13Sedative, hypnotic, or anxiolytic related disordersNo
F14Cocaine related disordersNo
F15Other stimulant related disordersNo
F16Hallucinogen related disordersNo
F17Nicotine dependenceNo
F18Inhalant related disordersNo
F19Other psychoactive substance related disordersNo

None of these is billable on its own — each is a category header. F17 is the exception in the range: ICD-10-CM titles it “nicotine dependence” rather than “nicotine related disorders”, and it has no abuse or use branch.

The fourth character: abuse, dependence or use

This is the axis that matters, and it is the same for every substance:

ICD-10-CM records all three as Excludes1 against each other within a substance. For cannabis that means F12.1- excludes F12.2- and F12.9-, and so on around. A claim carrying two of them for the same substance is contradictory, not merely redundant — and that is the single most common cause of a denial in this range. Different substances are fine together: cannabis dependence and alcohol abuse can both appear.

What follows, and why the codes get long

After the fourth character the code describes the complication. Cannabis dependence shows the shape:

CodeTitleBillable?
F12.2Cannabis dependence (incomplete)No
F12.20Cannabis dependence, uncomplicatedYes
F12.21Cannabis dependence, in remissionYes
F12.10Cannabis abuse, uncomplicatedYes
F12.11Cannabis abuse, in remissionYes
F12.90Cannabis use, unspecified, uncomplicatedYes

The uncomplicated and in-remission codes are the ones an outpatient behavioral health practice uses most. The longer codes in each family describe intoxication, withdrawal and substance-induced disorders, and run to six characters.

Note that .1 is remission at the fifth character but abuse at the fourth. F12.1 is cannabis abuse; F12.21 is cannabis dependence in remission. The position changes the meaning, which is why these codes are easy to transpose.

42 CFR Part 2 — why these records are different

Worth knowing even though it is not a coding rule. Records from federally assisted substance use disorder programmes carry protections under 42 CFR Part 2 that go beyond HIPAA, with their own consent requirements for disclosure. A diagnosis code on a claim is itself a disclosure. Practices treating substance use should understand whether Part 2 applies to them before deciding how these codes flow into shared systems, referrals or care-coordination tools.

DSM-5 crosswalk

DSM-5 collapsed DSM-IV's separate abuse and dependence diagnoses into a single substance use disorder graded mild, moderate or severe. ICD-10-CM did not follow and still splits abuse from dependence at the fourth character, so a clinician working from DSM-5 has a severity and the code set wants a category.

The crosswalk published by the American Psychiatric Association maps mild to the abuse branch (.1) and both moderate and severe to the dependence branch (.2), with the in-remission codes used where DSM-5 records early or sustained remission. Because moderate and severe share a code, the code itself does not preserve the DSM-5 severity — that belongs in the documentation.

CPT codes billed with substance use diagnoses

CPTServiceTime
90791Psychiatric diagnostic evaluation (no medical services)—
90832Individual psychotherapy16–37 minutes
90834Individual psychotherapy38–52 minutes
90837Individual psychotherapy53 minutes or more
90847Family psychotherapy, patient present50 minutes typical
90853Group psychotherapy—

A 50-minute session is 90834, not 90837 — 90837 begins at 53 minutes. CMS also sets a floor: psychotherapy under 16 minutes is not reported with these codes at all.

Check it live

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Frequently asked questions

Is F12.2 billable?

No. F12.2 is incomplete and needs a fifth character — F12.20 for uncomplicated, F12.21 for in remission. The same shape applies to every substance in F10 to F19.

What is the ICD-10 code for cannabis use disorder?

It depends on severity. Under the accepted DSM-5 crosswalk, mild maps to the abuse branch at F12.10 and moderate or severe to the dependence branch at F12.20.

Can you code abuse and dependence for the same substance?

No. ICD-10-CM lists abuse, dependence and use as Excludes1 against each other within a substance, so they are never reported together. Codes for different substances can appear together.

How are ICD-10 substance use codes structured?

The third character is the substance, the fourth is abuse (.1), dependence (.2) or use (.9), and the characters after that describe any complication such as intoxication or withdrawal.

What is the ICD-10 code for nicotine dependence?

The F17 family. ICD-10-CM titles F17 nicotine dependence rather than nicotine related disorders, and unlike the other substances it has no abuse or use branch.

Check a code with Afia — free

Codes on this page were verified against the CMS ICD-10-CM code sets for FY2026 and FY2027 (FY2027 effective 1 October 2026). Last reviewed 19 September 2026. Verify against the current official code set before submitting.