ICD-10 F10 Codes: Alcohol Abuse, Dependence

Alcohol-related disorders are the highest-volume diagnosis family in addiction treatment, and category F10 of ICD-10-CM is where every one of them is coded. Pick the wrong stem — abuse instead of dependence, use instead of abuse — and the claim that funds detox or residential care gets denied; pick the wrong specifier and the documentation no longer supports the level of care. This guide covers every billable F10 code in the FY2026 code set, the Official Guidelines rules that decide between them, and what payers expect to see at each level of care.

All codes and titles on this page are verified against the FY2026 ICD-10-CM code set (effective October 1, 2025), published by CDC/NCHS ↗ and CMS ↗. Coding rules cite the ICD-10-CM Official Guidelines for Coding and Reporting, FY2026 ↗, Section I.C.5.b. ICD-10-CM updates every October 1 — recheck codes at each fiscal-year rollover.

This page is part of our ICD-10 codes for mental and behavioral health directory.

F10 at a glance

Category F10, Alcohol related disorders, sits in ICD-10-CM Chapter 5 (Mental, Behavioral and Neurodevelopmental disorders, F01–F99). Every F10 code is built from one of three stems:

Clinicians diagnose in DSM-5-TR terms — a single alcohol use disorder (AUD) graded mild, moderate, or severe — while claims go out in ICD-10-CM, which still splits abuse from dependence. The FY2026 tabular list resolves the mismatch with inclusion terms:

After the stem, the 5th and 6th characters add the clinical specifier: uncomplicated, in remission, with intoxication, with withdrawal, or with an alcohol-induced disorder (mood, psychotic, anxiety, sexual dysfunction, sleep, persisting amnestic disorder, or dementia).

One instruction unique to F10 among the substance families: the tabular carries a “use additional code” note for blood alcohol level, Y90.-, when documented. Per Official Guidelines I.C.5.b.5, a Y90 code may be assigned when the BAC is documented and the provider has documented an F10-classifiable condition — and the BAC value itself does not need to come from the provider’s own note.

• Mild AUD → F10.10 (alcohol abuse, uncomplicated)
• Moderate or severe AUD → F10.20 (alcohol dependence, uncomplicated)
• Mild AUD in early or sustained remission → F10.11; moderate/severe AUD in remission → F10.21

Complete F10 code table (FY2026)

Every code below is a valid, billable FY2026 code unless marked as a header. Four- and five-character entries like F10.1, F10.12, and F10.23 are non-billable headers — claims must carry the full code.

F10.1- — Alcohol abuse

F10.2- — Alcohol dependence

F10.9- — Alcohol use, unspecified

Remember the F10.9- caveat: per Official Guidelines I.C.5.b.3, unspecified-use codes are assigned only on provider documentation and only when the use is associated with a substance-related disorder or medical condition, with that relationship documented. “Patient drinks socially” is not, by itself, a codable diagnosis.

The use–abuse–dependence hierarchy rule

The single most consequential rule in SUD coding — and the one no AI-scribe code page explains — is the hierarchy in Official Guidelines Section I.C.5.b.2. When provider documentation refers to use, abuse, and dependence of the same substance, only one code is assigned:

In practice: a history and physical that says “ETOH abuse” while the psychiatric evaluation documents “alcohol dependence with withdrawal” is coded once, to F10.23-, not to both stems. Submitting F10.10 alongside F10.230 on the same claim is a coding error that invites an audit finding.

The hierarchy only resolves conflicts within one substance. A patient with alcohol dependence and sedative dependence gets one code from F10.2- and one from F13.2- — each substance family is coded separately.

Coding alcohol use disorder in remission

Remission coding is governed by Official Guidelines Section I.C.5.b.1, and it is strictly documentation-driven: remission codes (-.11, -.21, -.91) “require the provider’s clinical judgment and are assigned only on the basis of provider documentation.” A coder may not infer remission from a clean toxicology screen or a discharge date.

The severity mapping carries into remission:

ICD-10-CM does not use separate codes for early versus sustained remission — both map to the same code, so the distinction lives in the clinical record, not the claim.

Why facilities should care: remission codes do real work in step-down care. A client moving from residential to PHP to IOP to outpatient may legitimately carry F10.21 in later phases — continuing-care services for a disorder in remission are common and payable in many benefit designs. But putting F10.21 on a claim for medically monitored detox contradicts itself: a patient in remission does not need withdrawal management. Utilization reviewers read the diagnosis and the requested level of care together; make sure they tell the same story. For how diagnosis interacts with multidimensional assessment at each transition, see our ASAM dimensions guide.

F10.20 deep dive: the workhorse code

F10.20 — alcohol dependence, uncomplicated — anchors more SUD claims than any other alcohol code. Its FY2026 inclusion terms are alcohol use disorder, moderate and alcohol use disorder, severe, which makes it the default code for most adults admitted to residential or intensive outpatient alcohol treatment.

Use F10.20 when dependence (moderate/severe AUD) is documented and the patient is not currently intoxicated, not in withdrawal, and has no documented alcohol-induced disorder:

For residential claims billed with HCPCS codes like H0017, H0018, and H0019, F10.20 is typically the principal diagnosis payers expect to see.

• F10.20 vs F10.22x: if the note documents acute intoxication at presentation, the intoxication codes (F10.220–F10.229) capture the encounter more specifically.
• F10.20 vs F10.23x: active withdrawal — documented symptoms or active withdrawal-management protocol — belongs in F10.230–F10.239. Coding F10.20 for a patient on day two of a withdrawal protocol undersells acuity and weakens the medical-necessity case for detox-level care.
• F10.20 vs F10.21: once the provider documents remission, switch to F10.21. Continuing to bill F10.20 months into sober outpatient care invites a continued-stay question — and switching too early undercuts the case for ongoing intensive treatment.

Alcohol withdrawal coding (F10.23x, F10.13x, F10.93x)

Withdrawal codes exist under all three stems in FY2026 — dependence (F10.230–F10.239), abuse (F10.130–F10.139), and unspecified use (F10.930–F10.939). The abuse-with-withdrawal subcategory F10.13- is a newer addition to the classification, closing an old gap where withdrawal could only be coded with dependence.

The 6th character carries the clinical severity:

Documentation that supports withdrawal codes: serial withdrawal-severity assessments (CIWA-Ar scores are the industry standard), vital-sign trends, time of last drink, the medication protocol ordered, and the provider’s diagnostic statement linking symptoms to alcohol withdrawal. A CIWA-Ar flowsheet alone is not a diagnosis — the provider must state the withdrawal diagnosis; the flowsheet corroborates it. SAMHSA ’s TIP 45 on detoxification ↗ describes the clinical framework most payers’ withdrawal-management criteria echo.

Withdrawal codes are what justify ambulatory or medically monitored withdrawal-management claims (e.g., H0010, H0011, H0014 ) — see the level-of-care section below.

• 0 uncomplicated — withdrawal symptoms without delirium or perceptual disturbance
• 1 delirium — withdrawal delirium (delirium tremens territory): a medical emergency
• 2 perceptual disturbance — hallucinosis without full delirium
• 9 unspecified — documentation doesn’t specify; expect specificity pushback from payers

”ETOH abuse” and other chart shorthand

Charts rarely speak in tabular-list language. The coder’s job is to translate — within strict limits:

The boundary rule: coders may not infer a diagnosis the provider has not made. Severity, remission status, and the abuse/dependence distinction all come from provider documentation; when the chart is ambiguous, the compliant route is a provider query, not a guess. Train clinicians to write “alcohol use disorder, moderate” or “alcohol dependence” — codable language — instead of shorthand.

Documentation requirements by code group

What the record needs to contain before each group of codes will survive an audit:

One more guideline worth pinning to the coding bay wall: medical complications of alcohol (pancreatitis, cirrhosis, gastritis) are not coded as alcohol-induced mental disorders. Per I.C.5.b.4, assign the medical condition’s own code (e.g., K85.2- for alcohol-induced acute pancreatitis) plus the appropriate F10 use/abuse/dependence code — not F10.288.

Medical necessity and billing by level of care

Diagnosis codes do not get claims paid by themselves — the diagnosis must support the billed service intensity. How F10 codes typically line up across the SUD continuum:

Payer-facing patterns worth auditing for in your own claims data:

Authorization criteria at each level usually track multidimensional assessment frameworks — see ASAM criteria and payer authorization for how diagnosis and dimensional severity interact in utilization review, and our guide to denial codes in addiction treatment billing for what comes back when the pairing fails. For the revenue-cycle side end to end, see behavioral health RCM.

carries the FY-current ICD-10-CM code set and scrubs claims pre-submission, and your clearinghouse adds a second scrubbing pass; expanded payer-rule scrubbing on the side is on our roadmap.

• Abuse-coded detox claims. F10.10 on a withdrawal-management claim is the classic self-inflicted denial; if withdrawal is being managed, a withdrawal code must appear.
• Remission codes on continued-stay reviews. F10.21 plus a request for more residential days reads as contradictory without explicit clinical justification.
• Specificity downgrades. F10.929/F10.939 (“unspecified”) codes draw requests for records that specific 6th-character codes avoid.
• Missing severity bridge. Notes that say only “AUD” without severity leave the abuse/dependence choice undocumented — and the auditor decides, not you.

Treatment planning for alcohol-related diagnoses

The diagnosis code is the root of the treatment plan: every goal, objective, and intervention should trace back to the documented F10 diagnosis, and the plan’s intensity should match the code’s acuity story. A plan for F10.230 (dependence with withdrawal) leads with stabilization and monitoring objectives; a plan for F10.21 (dependence in remission) leads with relapse-prevention and recovery-maintenance goals.

A fictional example, for illustration only: a 42-year-old admitted to residential care with F10.20 carries goals of completing a medically supervised taper (resolved before admission), engaging in 4× weekly group therapy, and developing a relapse-prevention plan; at 60 days the provider documents moderate AUD in early remission, the diagnosis moves to F10.21, and the plan steps down to IOP with maintenance goals. The code change and the plan change happen together, with provider documentation driving both.

Medication-assisted options for AUD (naltrexone, acamprosate) belong in the plan when clinically indicated — at the clinical-overview level, that means documenting the indication, the prescriber’s assessment, and monitoring objectives.

Build this out with our treatment plan guide and the related guide to ICD-10 codes in addiction treatment billing. For a plain-language definition of the underlying condition, see the alcohol use disorder glossary entry.

More ICD-10 resources

Codes verified against the FY2026 ICD-10-CM tabular list (effective October 1, 2025 – September 30, 2026). This page is reviewed against each annual ICD-10-CM update.

Diagnosis is step one; getting the claim paid is the other nine. ’s EHR connects diagnosis, treatment planning, and billing in one platform built for addiction treatment — request a demo.

Reference tables

Common questions

Official sources

• CDC/NCHScdc.gov
• CMScms.gov
• ICD-10-CM Official Guidelines for Coding and Reporting, FY2026ftp.cdc.gov
• TIP 45 on detoxificationncbi.nlm.nih.gov