What is the ICD-10 (International Classification of Diseases, 10th Revision) code for alcohol abuse?

ICD-10 Coding for Alcohol Abuse

The ICD-10 does not specifically classify "alcohol abuse" as a distinct entity due to ambiguity in its definition. 1

Understanding Alcohol-Related Diagnoses in ICD-10

In the ICD-10 classification system, alcohol-related disorders are primarily coded under the F10 category. However, unlike the DSM-IV which divided alcohol use disorder into "alcohol abuse" and "alcohol dependence," the ICD-10 takes a different approach:

• The concept of "alcohol abuse" as a distinct entity is not classified in ICD-10 1
• Instead, ICD-10 uses categories such as:
  • F10.1 - Harmful use of alcohol
  • F10.2 - Alcohol dependence syndrome
  • F10.0 - Acute alcohol intoxication
  • F10.3-F10.9 - Various alcohol-induced conditions

Why ICD-10 Doesn't Include "Alcohol Abuse"

The World Health Organization (WHO) intentionally omitted "alcohol abuse" from ICD-10 due to:

• Ambiguity in the definition of alcohol abuse 1
• Difficulty in establishing clear diagnostic boundaries
• Preference for more clinically useful classifications

Appropriate Coding Options

When documenting what would be considered "alcohol abuse" in other systems:

1. F10.1 - Harmful use of alcohol is the most appropriate code for patients who drink despite recurrent social, interpersonal, and legal problems as a result of alcohol use 1

2. F10.2 - Alcohol dependence syndrome should be used when physiological dependence is present with significant problems in the person's life 1

Clinical Implications

• The DSM-5 has moved away from the abuse/dependence dichotomy to an "alcohol use disorder" spectrum with mild, moderate, and severe classifications 1
• When converting from DSM terminology to ICD-10 coding:
  • Mild-moderate alcohol use disorder generally maps to F10.1 (Harmful use)
  • Severe alcohol use disorder generally maps to F10.2 (Dependence syndrome)

Screening Considerations

• AUDIT (Alcohol Use Disorders Identification Test) remains the gold standard screening tool 1
• CAGE questionnaire is simpler but has lower sensitivity for hazardous drinking 1
• Positive screenings should lead to appropriate coding and intervention

Important Caveats

• Avoid using outdated terminology that doesn't align with current classification systems
• Document specific alcohol-related behaviors and consequences to support appropriate coding
• Be aware that ICD-11 has been published with revised criteria for substance use disorders, though many healthcare systems still use ICD-10 2, 3