ICD-10: F14.92

ICD-10 code F14.922 refers specifically to "Cocaine use, unspecified, with intoxication." This classification falls under the broader category of cocaine-related disorders, which are detailed in the ICD-10-CM (International Classification of Diseases, 10th Revision, Clinical Modification) coding system. Below is a comprehensive overview of this code, including clinical descriptions, diagnostic criteria, and implications for treatment and management.

Clinical Description

Definition

Cocaine use disorder is characterized by the compulsive use of cocaine, leading to significant impairment or distress. The specific code F14.922 indicates that the individual is currently experiencing intoxication due to cocaine use, but the specifics of the use (such as frequency or method of administration) are unspecified. Intoxication refers to the acute effects of cocaine, which can include euphoria, increased energy, and heightened alertness, but may also lead to adverse effects such as anxiety, paranoia, and cardiovascular complications.

Symptoms of Intoxication

Cocaine intoxication can manifest through a variety of symptoms, including:
- Euphoria: A heightened sense of well-being or elation.
- Increased Energy: Enhanced physical and mental activity.
- Decreased Appetite: Reduced desire to eat.
- Increased Heart Rate: Tachycardia and elevated blood pressure.
- Dilated Pupils: A common physiological response.
- Anxiety or Paranoia: Heightened feelings of anxiety or suspiciousness.

In severe cases, intoxication can lead to more serious complications, such as:
- Cardiovascular Events: Including heart attack or stroke.
- Seizures: Neurological disturbances that may occur.
- Hyperthermia: Elevated body temperature due to increased metabolic activity.

Diagnostic Criteria

Criteria for Diagnosis

The diagnosis of cocaine use disorder with intoxication typically involves the following criteria, as outlined in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition):
1. Use of Cocaine: Evidence of cocaine use leading to significant impairment or distress.
2. Intoxication Symptoms: Presence of symptoms consistent with cocaine intoxication.
3. Duration: Symptoms must occur during or shortly after cocaine use.

Unspecified Use

The term "unspecified" in the code indicates that while the individual is experiencing intoxication, the specifics regarding the pattern of use (e.g., frequency, duration, or context) are not detailed. This can occur in clinical settings where the patient may not provide a full history or when the clinician determines that the specifics are not necessary for the immediate treatment plan.

Implications for Treatment

Management Strategies

Treatment for individuals diagnosed with F14.922 typically involves a combination of medical and psychological interventions:
- Detoxification: Medical supervision may be necessary to manage withdrawal symptoms and ensure safety.
- Behavioral Therapies: Cognitive-behavioral therapy (CBT) and contingency management are effective in addressing substance use disorders.
- Support Groups: Participation in support groups such as Narcotics Anonymous can provide community support and accountability.

Monitoring and Follow-Up

Ongoing monitoring is crucial for individuals with cocaine use disorder. Regular follow-up appointments can help assess progress, manage any co-occurring mental health issues, and adjust treatment plans as necessary.

Conclusion

ICD-10 code F14.922 serves as a critical classification for healthcare providers dealing with patients experiencing cocaine use and intoxication. Understanding the clinical implications, diagnostic criteria, and treatment options associated with this code is essential for effective management and support of individuals affected by cocaine-related disorders. Proper coding not only aids in treatment planning but also ensures accurate documentation for billing and insurance purposes, ultimately contributing to better patient outcomes.

Cocaine use, particularly when classified under ICD-10 code F14.92, indicates a diagnosis of cocaine use disorder with unspecified intoxication. This classification encompasses a range of clinical presentations, signs, symptoms, and patient characteristics that are crucial for healthcare providers to recognize for effective diagnosis and treatment.

Clinical Presentation

Overview of Cocaine Intoxication

Cocaine intoxication can manifest in various ways, depending on the route of administration (e.g., snorting, injecting, or smoking) and the amount consumed. The effects of cocaine are typically acute and can lead to significant physiological and psychological changes.

Signs and Symptoms

The signs and symptoms of cocaine intoxication can be categorized into physical, psychological, and behavioral manifestations:

Physical Signs

• Cardiovascular Effects: Increased heart rate (tachycardia), elevated blood pressure (hypertension), and potential arrhythmias are common. Severe cases may lead to myocardial infarction or stroke due to vasoconstriction and increased myocardial oxygen demand[1][2].
• Neurological Symptoms: Patients may experience headaches, seizures, or altered mental status, including confusion or agitation[3].
• Respiratory Changes: Hyperventilation or respiratory distress may occur, particularly in cases of overdose[4].

Psychological Symptoms

• Euphoria: A heightened sense of well-being or intense pleasure is often reported shortly after use[5].
• Anxiety and Paranoia: Many users experience anxiety, paranoia, or even hallucinations, especially with higher doses or prolonged use[6].
• Mood Swings: Rapid changes in mood, including irritability or aggression, can be observed[7].

Behavioral Changes

• Increased Energy and Activity: Users may exhibit hyperactivity, restlessness, or an inability to sit still[8].
• Impulsivity: Decision-making may be impaired, leading to risky behaviors or poor judgment[9].
• Social Withdrawal: In chronic users, there may be a tendency to withdraw from social interactions or responsibilities[10].

Patient Characteristics

Demographics

• Age: Cocaine use is prevalent among younger adults, particularly those aged 18-34, although use can occur in older populations as well[11].
• Gender: Males are more likely to use cocaine than females, although the gender gap has been narrowing in recent years[12].
• Socioeconomic Status: Cocaine use is often associated with lower socioeconomic status, but it can also be found across various socioeconomic groups[13].

Comorbid Conditions

Patients with cocaine use disorder frequently present with comorbid mental health disorders, such as:
- Depression: Many individuals may have underlying depressive disorders that contribute to substance use[14].
- Anxiety Disorders: Anxiety disorders are common among cocaine users, exacerbating the cycle of use and dependence[15].
- Other Substance Use Disorders: Polysubstance use is prevalent, with many individuals using alcohol, opioids, or other stimulants alongside cocaine[16].

History of Use

• Duration and Frequency: The history of cocaine use can vary widely, with some patients being occasional users while others may have a long-standing history of daily use[17].
• Previous Treatment Attempts: Many patients may have attempted treatment for substance use disorders previously, which can influence their current presentation and treatment approach[18].

Conclusion

Understanding the clinical presentation, signs, symptoms, and patient characteristics associated with ICD-10 code F14.92 is essential for healthcare providers. Recognizing these factors can aid in the timely diagnosis and management of cocaine use disorder with intoxication, ultimately improving patient outcomes. Effective treatment often requires a comprehensive approach that addresses both the substance use and any underlying mental health issues, emphasizing the importance of integrated care strategies.

References

1. Trends of Cocaine Use and Manifestations in Hospitalized Patients.
2. Using ICD-10-CM codes to detect illicit substance use.
3. Cocaine Use Disorder (CUD): Current Clinical Perspectives.
4. Controlled Substance Monitoring and Drugs of Abuse Testing.
5. The ICD-10 Classification of Mental and Behavioural Disorders.
6. Substance Use, Abuse, and Dependence CDI Pocket.
7. F19 Mental and behavioural disorders due to psychoactive substances.
8. Signs of Cocaine Use | How To Tell If Someone Uses Cocaine - DrugRehab.com.
9. 2025 ICD-10-CM Diagnosis Code F14: Cocaine related disorders.
10. 2025 ICD-10-CM Diagnosis Code F14.90: Cocaine use, unspecified.
11. Trends of Cocaine Use and Manifestations in Hospitalized Patients.
12. Cocaine Use Disorder (CUD): Current Clinical Perspectives.
13. Using ICD-10-CM codes to detect illicit substance use.
14. Substance Use, Abuse, and Dependence CDI Pocket.
15. Controlled Substance Monitoring and Drugs of Abuse Testing.
16. The ICD-10 Classification of Mental and Behavioural Disorders.
17. F19 Mental and behavioural disorders due to psychoactive substances.
18. 2025 ICD-10-CM Diagnosis Code F14: Cocaine related disorders.

ICD-10 code F14.92 refers specifically to "Cocaine use, unspecified with intoxication." This classification falls under the broader category of cocaine-related disorders. Understanding alternative names and related terms can be beneficial for healthcare professionals, researchers, and those involved in billing and coding. Below is a detailed overview of alternative names and related terms associated with this ICD-10 code.

Alternative Names for F14.92

1. Cocaine Intoxication: This term is often used interchangeably with F14.92, emphasizing the acute effects of cocaine use.
2. Cocaine Use Disorder: While this term generally refers to a broader pattern of cocaine use, it can sometimes be used in contexts where intoxication is implied.
3. Cocaine Abuse: This term may be used in clinical settings to describe harmful patterns of cocaine use leading to intoxication.
4. Cocaine Dependency: Although more specific to chronic use, it can relate to cases where intoxication occurs.

Related Terms

1. Cocaine-Related Disorders: This encompasses a range of conditions associated with cocaine use, including intoxication, withdrawal, and dependence.
2. Substance Use Disorder: A broader category that includes cocaine use disorder, highlighting the impact of various substances, including cocaine.
3. Cocaine Toxicity: This term refers to the harmful effects resulting from cocaine use, which can include symptoms of intoxication.
4. Cocaine Withdrawal: While not directly synonymous with intoxication, it is a related condition that may follow periods of cocaine use.
5. Cocaine Overdose: This term is used when the amount of cocaine consumed leads to severe physiological effects, often requiring medical intervention.

Clinical Context

In clinical practice, the use of ICD-10 codes like F14.92 is crucial for accurate diagnosis, treatment planning, and billing. Understanding the nuances of these terms can aid healthcare providers in documenting patient conditions effectively. For instance, distinguishing between "cocaine intoxication" and "cocaine use disorder" is essential for appropriate treatment strategies and insurance claims.

Conclusion

ICD-10 code F14.92, representing "Cocaine use, unspecified with intoxication," is associated with various alternative names and related terms that reflect the complexities of cocaine use and its effects. Familiarity with these terms is vital for healthcare professionals involved in diagnosing and treating substance use disorders, ensuring accurate communication and documentation in clinical settings.

Cocaine use disorder, particularly when classified under ICD-10 code F14.92, indicates a diagnosis of cocaine use with unspecified intoxication. This condition requires a comprehensive treatment approach that addresses both the immediate effects of intoxication and the underlying substance use disorder. Below, we explore standard treatment strategies, including medical, psychological, and supportive interventions.

Understanding Cocaine Use Disorder

Cocaine is a powerful stimulant that can lead to significant psychological and physical health issues. The diagnosis of F14.92 encompasses individuals experiencing acute intoxication, which may present with symptoms such as increased energy, euphoria, heightened alertness, and, in severe cases, agitation, paranoia, or cardiovascular complications[1]. Treatment must be tailored to the individual's needs, considering the severity of intoxication and any co-occurring disorders.

Immediate Medical Management

1. Emergency Care

In cases of acute intoxication, immediate medical attention is crucial. Emergency departments typically focus on stabilizing the patient, which may involve:

• Monitoring Vital Signs: Continuous assessment of heart rate, blood pressure, and respiratory function is essential.
• Sedation: Benzodiazepines may be administered to manage severe agitation or anxiety, helping to calm the patient and reduce the risk of complications[2].
• Cardiovascular Support: If the patient exhibits signs of cardiovascular distress, treatments may include medications to manage hypertension or arrhythmias.

2. Detoxification

Following stabilization, detoxification may be necessary. This process involves the safe withdrawal from cocaine, often requiring medical supervision to manage withdrawal symptoms, which can include fatigue, depression, and cravings[3].

Psychological and Behavioral Interventions

1. Cognitive Behavioral Therapy (CBT)

CBT is a widely used therapeutic approach for treating substance use disorders. It helps individuals identify and change negative thought patterns and behaviors associated with cocaine use. CBT can also equip patients with coping strategies to handle triggers and cravings[4].

2. Motivational Interviewing (MI)

MI is a client-centered counseling style that enhances motivation to change. It is particularly effective in engaging individuals who may be ambivalent about treatment, helping them to explore their reasons for change and commitment to recovery[5].

3. Contingency Management

This behavioral therapy provides tangible rewards for positive behaviors, such as maintaining sobriety. It has shown effectiveness in promoting abstinence from cocaine use by reinforcing positive changes[6].

Supportive Services

1. Group Therapy

Participating in group therapy can provide social support and shared experiences among individuals facing similar challenges. This setting fosters a sense of community and accountability, which can be beneficial in recovery[7].

2. 12-Step Programs

Programs like Narcotics Anonymous (NA) offer peer support and a structured approach to recovery. These programs emphasize the importance of community and shared experiences in overcoming addiction[8].

3. Family Therapy

Involving family members in the treatment process can help address relational dynamics that may contribute to substance use. Family therapy can improve communication and support systems, which are vital for long-term recovery[9].

Conclusion

The treatment of cocaine use disorder, particularly under the ICD-10 code F14.92, requires a multifaceted approach that includes immediate medical care, psychological interventions, and supportive services. By addressing both the acute effects of intoxication and the underlying addiction, healthcare providers can help individuals achieve recovery and improve their overall quality of life. Continuous follow-up and support are essential to prevent relapse and promote sustained recovery.

For individuals or families seeking help, it is crucial to consult healthcare professionals who specialize in addiction treatment to develop a personalized care plan.

The ICD-10 code F14.92 refers to "Cocaine use, unspecified with intoxication." This diagnosis is part of the broader category of cocaine-related disorders, which are classified under the F14 codes in the ICD-10-CM (International Classification of Diseases, 10th Revision, Clinical Modification). To accurately diagnose this condition, healthcare professionals typically rely on specific criteria that align with the diagnostic guidelines established by the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) and the ICD-10.

Diagnostic Criteria for Cocaine Use Disorder

The diagnosis of cocaine use disorder, which may lead to the use of the F14.92 code, generally involves the following criteria:

1. Pattern of Use: The individual has a pattern of cocaine use that leads to significant impairment or distress, as manifested by at least two of the following within a 12-month period:
   - Taking cocaine in larger amounts or over a longer period than intended.
   - Persistent desire or unsuccessful efforts to cut down or control cocaine use.
   - A great deal of time spent in activities necessary to obtain cocaine, use it, or recover from its effects.
   - Craving, or a strong desire or urge to use cocaine.
   - Recurrent use resulting in a failure to fulfill major role obligations at work, school, or home.
   - Continued use despite having persistent social or interpersonal problems caused or exacerbated by the effects of cocaine.
   - Important social, occupational, or recreational activities are given up or reduced because of cocaine use.
   - Recurrent use in situations where it is physically hazardous.
   - Continued use despite knowing that it is causing or worsening a physical or psychological problem.

2. Intoxication Symptoms: Cocaine intoxication is characterized by a range of symptoms that may include:
   - Euphoria or an intense feeling of well-being.
   - Increased energy and alertness.
   - Decreased appetite.
   - Increased heart rate and blood pressure.
   - Dilated pupils.
   - Increased talkativeness or sociability.
   - Anxiety, paranoia, or irritability.

3. Severity: The severity of the disorder can be classified as mild, moderate, or severe based on the number of criteria met:
   - Mild: 2-3 criteria.
   - Moderate: 4-5 criteria.
   - Severe: 6 or more criteria.

Additional Considerations

• Exclusion of Other Disorders: It is essential to rule out other mental health disorders that may present with similar symptoms, ensuring that the diagnosis of cocaine use disorder is accurate.
• Context of Use: The context in which cocaine is used (e.g., recreational, social, or as a coping mechanism) can also provide insight into the severity and implications of the disorder.

Conclusion

The diagnosis of F14.92, "Cocaine use, unspecified with intoxication," requires a comprehensive assessment of the individual's use patterns, symptoms of intoxication, and the impact on their daily functioning. Clinicians must utilize the established criteria from the DSM-5 and ICD-10 to ensure accurate diagnosis and appropriate treatment planning. Understanding these criteria is crucial for effective intervention and support for individuals struggling with cocaine use and its associated challenges[1][2][3][4].