Template:ICD10 Guideline Chronic Substance Abuse

This template puts the rules for chronic substance abuse into the relevant diagnoses.

To use:

{{ICD10 Guideline Chronic Substance Abuse}}

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Coding substance related ICD10 diagnoses

See ICD10 Guideline for drugs and substances for more info on coding substance related ICD10 diagnoses.

Chronic Substance Abuse Guidelines

• This category indicates, as stated, that the patient has, for the indicated substance, chronic abuse and/or dependency/addiction
• Chronic abuse/dependence/addiction does not necessarily mean there is current acute intoxication or withdrawal
• This is almost always going to be a Comorbid Diagnosis

• The issue of "chronic abuse/dependence/addiction" is hard to pin down and comes down to a judgment call (specifically, the judgment of collectors and the physicians writing chart notes):
• Obviously it is present if CURRENT dependence or addiction is present.
• But it can exist even in the absence of identified dependence or addiction, if chronic abuse is present.
• There are actually TWO judgments required to identify chronic abuse: (a) what is heavy use, and (b) what duration qualifies as chronic use
  • Furthermore, and complicating the issue, is that chronic abuse is about BOTH duration and quantity.
  • Heavier use for shorter periods COULD be considered as chronic abuse.
  • e.g. even without dependence or addiction, >5 years of heavy or regular use qualifies as "chronic abuse"
  • But the actual CUTOFF for the duration that qualifies as "chronic" is not easily delineated and depends somewhat on how heavy the use is
    • So again, the bottom line for defining "chronic abuse" is a judgment call

Do not code for past drug use

Do NOT include the chronic abuse/dependence/addiction code if the person is no longer using, but DO code any resulting long-term problem, e.g. liver cirrhosis as a result of past alcohol abuse, or ischemic heart disease as a result past cocaine abuse.