Focus On Drug Dependence versus Abuse to Assign Diagnosis

ICD-9 does not provide a specific code for a urine drug test. The same is the case with ICD-10 too. The proper diagnosis code for billing a lab drug test depends on the signs, symptoms, patient condition, or other reason for the test, say for instance screening.

Example: The physician orders a drug screen for a patient diagnosed with Cannabis dependence who uses the drug intermittently. Code the ordering diagnosis as 304.32 (Cannabis dependence, episodic use) with ICD-9.

Cross walking from ICD-9 to ICD-10: Even though ICD-10 provides more detail than ICD-9, leading to more code choices for ICD-10, the opposite is correct in this instance. The subsequent three ICD-9 codes crosswalk to a single ICD-10 code (F12.20, Cannabis dependence, uncomplicated):

304.30 -- Cannabis dependence, unspecified use

304.31 -- Cannabis dependence, continuous use

304.32 -- Cannabis dependence, episodic use.

Report different codes for abuse or use

Both ICD-9 as well as ICD-10 differentiates between drug dependence versus drug abuse. For example, 304.3x identifies Cannabis dependence while 305.2x (Non-dependent Cannabis abuse) identifies Cannabis abuse.

Likewise, ICD-10 provides F12.20 for Cannabis dependence, and F12.10 (Cannabis abuse, uncomplicated) for Cannabis abuse.

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What's more, ICD-10 provides separate codes for drug use when the doctor does not specify whether the use constitutes dependence or abuse. For example, you would code Cannabis use as F12.90 (Cannabis use, unspecified, uncomplicated).