ICD Code F10.21

ICD code F10.21 is used to indicate that a patient has a history of alcohol dependence but is currently in remission. This means that the individual previously met the criteria for alcohol dependence but is not currently exhibiting symptoms of active dependence. This code is important for healthcare providers to document the patient's history accurately and to guide ongoing treatment and monitoring strategies.

1. History of Alcohol Dependence: The patient must have a documented history of alcohol dependence, indicating a previous pattern of compulsive alcohol use, tolerance, and withdrawal symptoms.

2. Current Remission Status: The patient is currently not exhibiting any active symptoms of alcohol dependence. This includes the absence of cravings, loss of control over alcohol use, and continued use despite negative consequences.

3. Sustained Abstinence: The patient has maintained abstinence from alcohol for a significant period, typically at least three months, without any relapse into alcohol use.

4. Ongoing Monitoring and Support: The patient is actively participating in a recovery program or receiving ongoing support to maintain remission. This may include counseling, support groups, or medical supervision.

5. Absence of Withdrawal Symptoms: The patient does not exhibit any withdrawal symptoms, which are typically present during active dependence or early stages of recovery.

6. Psychosocial Stability: The patient demonstrates stability in social, occupational, and interpersonal functioning, which may have been previously impaired due to alcohol dependence.

7. No Use of Substitute Substances: The patient is not using other substances as a substitute for alcohol, which could indicate a transfer of dependence rather than true remission.

8. Regular Follow-up: The patient is engaged in regular follow-up appointments with healthcare providers to monitor their remission status and address any potential risk factors for relapse.

For the ICD code F10.21 (Alcohol dependence, in remission), the relevant CPT codes that may be applicable include:

1. 99201-99215 - Evaluation and Management (E/M) services, which can be used for office or other outpatient visits.

2. 90832, 90834, 90837 - Psychotherapy services, depending on the duration of the session (30, 45, or 60 minutes respectively).

3. 90846, 90847 - Family psychotherapy, with or without the patient present.

4. H0001 - Alcohol and/or drug assessment.

5. H0004 - Behavioral health counseling and therapy.

6. H0005 - Alcohol and/or drug services; group counseling by a clinician.

7. H0038 - Self-help/peer services, per 15 minutes.

8. G0396, G0397 - Alcohol and/or substance abuse structured assessment and intervention services.

These CPT codes are commonly used in the treatment and management of patients with alcohol dependence in remission, providing a range of services from evaluation and management to psychotherapy and counseling. Always ensure to verify the specific services provided and payer guidelines when selecting CPT codes.

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