The ICD-10-CM code for alcohol abuse with intoxication, delirium (F10.121) is used to report cases where a patient has a documented pattern of alcohol abuse and presents with acute intoxication accompanied by delirium.
This code is critical for accurate medical billing, risk adjustment, clinical communication, and compliance, especially in emergency, inpatient, and behavioral health settings where alcohol-related complications are treated.
ICD Code Description
ICD-10-CM Code: F10.121
Diagnosis: Alcohol abuse with intoxication, delirium
This diagnosis applies when a patient with alcohol abuse experiences acute alcohol intoxication severe enough to cause delirium, characterized by disturbances in consciousness, cognition, perception, or behavior.
Clinical Specificity
- Condition: Alcohol abuse (not dependence)
- Acuity: Acute intoxication
- Severity: With delirium (confusion, disorientation, agitation)
- Laterality: Not applicable
- Status: Active condition requiring medical attention
Category & Code Type
ICD-10-CM Chapter
-
Chapter 5: Mental, Behavioral and Neurodevelopmental Disorders (F01–F99)
ICD-10 Category
- F10 – Mental and behavioral disorders due to use of alcohol
- F10.12 – Alcohol abuse with intoxication
Code Type
- F10.121 is a billable and specific ICD-10-CM code
- Valid for reimbursement in inpatient and outpatient settings
Includes / Excludes Notes
Includes:
- Alcohol abuse with acute intoxication
- Alcohol-related delirium due to intoxication
Excludes:
- Alcohol dependence with intoxication or delirium (F10.22-, F10.23-)
- Alcohol withdrawal delirium (F10.231)
- Alcohol abuse without intoxication (F10.10)
- Alcohol intoxication without delirium (F10.120)
Correct code selection depends on clear provider documentation.
Coding Guidelines
When assigning F10.121, follow these ICD-10-CM coding principles:
- Code based on provider diagnosis, not symptoms alone
- Delirium must be explicitly documented
- Do not code alcohol abuse if alcohol dependence is documented—dependence takes precedence
- Do not confuse intoxication delirium with withdrawal delirium
- Use the most specific F10 code available
Billing Considerations
Reimbursement Impact
- Supports higher-acuity services such as ED visits, inpatient admissions, ICU monitoring, and psychiatric evaluation
- Often impacts DRG assignment, severity of illness, and risk adjustment
Payer Considerations
- Payers may require documentation of mental status changes
- Alcohol-related diagnoses may trigger medical necessity reviews
- Often bundled with toxicology testing, imaging, and observation services
Documentation Tips
Strong documentation should clearly support all components of the diagnosis:
- Explicit diagnosis of alcohol abuse
- Clinical confirmation of intoxication
- Clear documentation of delirium (e.g., confusion, hallucinations, disorientation)
- Timing and severity of symptoms
- Treatment rendered (IV fluids, monitoring, restraints, medications)
Avoid vague terms like “altered” without clarifying delirium.
Common Clinical Examples
- Emergency department visit for acute alcohol intoxication with agitation and confusion
- Hospital admission for alcohol-related delirium following binge drinking
- Psychiatric consult for disorientation caused by severe intoxication
- Observation stay due to unsafe behavior related to intoxication delirium
Common Errors & Denials
Frequent coding mistakes include:
- Using F10.121 when delirium is not documented
- Confusing intoxication delirium with withdrawal delirium
- Coding abuse instead of dependence
- Assigning unspecified intoxication codes when specificity is available
These errors can lead to claim denials, audits, or downcoding.
Key Takeaways
- F10.121 represents alcohol abuse with acute intoxication and delirium
- It is a billable, high-acuity ICD-10-CM code
- Clear documentation of delirium is essential
- Dependence overrides abuse if both are documented
- Accurate coding supports reimbursement and clinical severity reporting
FAQ
What is the ICD-10 code for alcohol abuse with intoxication and delirium?
The correct ICD-10-CM code is F10.121.
Is F10.121 a billable diagnosis code?
Yes, F10.121 is billable and valid for reimbursement.
What documentation is required to use F10.121?
Providers must document alcohol abuse, intoxication, and delirium explicitly.
Can F10.121 be used for alcohol withdrawal delirium?
No. Alcohol withdrawal delirium is coded to F10.231.
What is the difference between intoxication delirium and withdrawal delirium?
Intoxication delirium occurs during acute alcohol consumption, while withdrawal delirium occurs after cessation or reduction of alcohol intake.
