ICD-10 Diagnosis Codes for Benzodiazepine Use
Based on the clinical context and pattern of use, the appropriate ICD-10 diagnosis codes for benzodiazepine use are:
Primary Diagnostic Codes
For therapeutic/prescribed benzodiazepine use without complications:
- Z79.4 - Long-term (current) use of insulin (Note: While guidelines reference benzodiazepine use extensively 1, the specific ICD-10 code for therapeutic benzodiazepine use follows the Z-code structure for long-term medication use)
For problematic benzodiazepine use patterns:
Benzodiazepine Use Disorder
- F13.10 - Sedative, hypnotic, or anxiolytic use disorder, mild (uncomplicated) 2, 3
- F13.20 - Sedative, hypnotic, or anxiolytic use disorder, moderate or severe (uncomplicated) 2, 4
- F13.21 - Sedative, hypnotic, or anxiolytic use disorder, moderate or severe, in remission 4, 5
Benzodiazepine Dependence
- F13.20 - Sedative, hypnotic, or anxiolytic dependence, uncomplicated 2, 3, 5
- F13.23 - Sedative, hypnotic, or anxiolytic dependence with withdrawal 1, 3, 5
- F13.239 - Sedative, hypnotic, or anxiolytic dependence with withdrawal, unspecified 3, 5
Benzodiazepine Abuse
- F13.10 - Sedative, hypnotic, or anxiolytic abuse, uncomplicated 2, 3
- F13.120 - Sedative, hypnotic, or anxiolytic abuse with intoxication, uncomplicated 2
Benzodiazepine Poisoning/Overdose
- T42.4X1A - Poisoning by benzodiazepines, accidental (unintentional), initial encounter 1
- T42.4X2A - Poisoning by benzodiazepines, intentional self-harm, initial encounter 1
- T42.4X4A - Poisoning by benzodiazepines, undetermined, initial encounter 1
Clinical Context for Code Selection
Distinguish between normal therapeutic use and problematic use:
- Pharmacologic dependence from legitimate prescribed use (requiring tapering when discontinuing) does not constitute addiction and should be coded as therapeutic use 2, 6
- True abuse involves intentional misuse, typically as a secondary drug to augment other substances or offset adverse effects of other drugs 2, 3
- Physical dependence manifesting as withdrawal symptoms upon abrupt discontinuation is a predictable physiological adaptation, not abuse 2, 5
Key clinical indicators for problematic use codes:
- Use beyond prescribed duration (typically beyond 2-4 weeks for anxiety, beyond 2 weeks for insomnia) 6
- Dose escalation beyond therapeutic range 6, 3
- Concurrent substance abuse 2, 3
- Doctor shopping or obtaining from non-medical sources 2
- Continued use despite harm 3, 4
Common pitfall: Do not code long-term therapeutic benzodiazepine use for chronic anxiety as "dependence" or "abuse" - approximately one-third of long-term users will experience withdrawal symptoms, but this represents normal physiological dependence, not a use disorder 2, 3.