Guidelines › Substance use, abuse and dependence: only one code

Substance use, abuse and dependence: only one code

Official text from the FY2027 ICD-10-CM Official Guidelines for Coding and Reporting. The wording is quoted exactly.

Guidelines I.C.5.b.2

“When the provider documentation refers to use, abuse and dependence of the same substance (e.g. alcohol, opioid, cannabis, etc.), only one code should be assigned to identify the pattern of use based on the following hierarchy:”

“If both use and abuse are documented, assign only the code for abuse”

“If both abuse and dependence are documented, assign only the code for dependence”

“If use, abuse and dependence are all documented, assign only the code for dependence”

“If both use and dependence are documented, assign only the code for dependence.”

Where this applies

458 billable codes. Source: FY 2027 ICD-10-CM Official Guidelines for Coding and Reporting, effective October 1, 2026. Full Guidelines (PDF, CMS)