With use disorder, Without disorder, moderate use
Alcohol 291.89 F10.181 F10.281 F10.981
Opioid 292.89 F11.181 F11.281 F11.981
Sedative, hypnotic, or 292.89 F13.181 F13.281 F13.981
Amphetamine (or other 292.89 F15.181 F15.281 F15.981
Cocaine 292.89 F14.181 F14.281 F14.981
Other (or unknown) substance 292.89 F19.181 F19.281 F19.981
Specify it (see Table 1 in the chapter “Substance-Related and Addictive Disorders" for di- agnoses associated with substance class):
With onset during intoxication: If the criteria are met for intoxication with the sub- stance and the symptoms develop during intoxication.
With onset during withdrawal: If criteria are met for withdrawal from the substance and the symptoms develop during, or shortly after, withdrawal.
With onset after medication use: Symptoms may appear either at initiation of medi- cation or after a modification or change in use.
Specify current severity:
Mild: Occurs on 25%—50% of occasions of sexual activity.
Moderate: Occurs on 50%-75% of occasions of sexual activity.
Severe: Occurs on 75% or more of occasions of sexual activity.
|CD-9-CM. The name of the substance/medication-induced sexual dysfunction begins with the specific substance (e.g., alcohol, ﬂuoxetine) that is presumed to be causing the sexual dysfunction. The diagnostic code is selected from the table included in the criteria set, which is based on the drug class. For substances that do not fit into any of the classes (e.g., ﬂuoxetine), the code for ”other substance” should be used; and in cases in which a substance is judged to be an etiological factor but the specific class of substance is un- known, the category ”unknown substance” should be used.
The name of the disorder is followed by the specification of onset (i.e., onset during in- toxication, onset during withdrawal, with onset after medication use), followed by the se- verity specifier (e.g., mild, moderate, severe). Unlike the recording procedures for ICD-10-
CM, which combine the substance-induced disorder and substance use disorder into a sin- gle code, for ICD-9-CM a separate diagnostic code is given for the substance use disorder.
For example, in the case of erectile dysfunction occurring during intoxication in a man with a severe alcohol use disorder, the diagnosis is 291.89 alcohol-induced sexual dysfunc- tion, with onset during intoxication, moderate. An additional diagnosis of 303.90 severe alcohol use disorder is also given. When more than one substance is judged to play a sig- nificant role in the development of the sexual dysfunction, each should be listed separately (e.g., 292.89 cocaine-induced sexual dysfunction with onset during intoxication, moderate; 292.89 ﬂuoxetine-induced sexual dysfunction, with onset after medication use).