500 Substance-Related and Addictive Disorders
D. The signs or symptoms are not attributable to another medical condition and are not
better explained by another mental disorder, including intoxication or withdrawal from
another substance.
Specify if:
With perceptual disturbances:  This specifier applies in the rare instance when hal-
lucinations (usually visual or tactile) occur with intact reality testing, or auditory, visual,
or tactile illusions occur in the absence of a delirium.
Coding note:  The ICD-9-CM code is 291.81. The ICD-10-CM code for alcohol withdrawal
without perceptual disturbances is F10.239,  and the ICD-10-CM code for alcohol withdrawal
with perceptual disturbances is F10.232.  Note that the ICD-10-CM code indicates the comor-
bid presence of a moderate or severe alcohol use disorder, reflecting the fact that alcohol with-
drawal can only occur in the presence of a moderate or severe alcohol use disorder. It is not
permissible to code a comorbid mild alcohol use disorder with alcohol withdrawal.
Specifiers
When hallucinations occur in the absence of delirium (i.e., in a clea r sensorium), a diagno-
sis of substance/medication-induced ps ychotic disorder should be considered.
Diagnostic Features
The essential feature of alcoho l withdrawal is the presence of a characteristic withdrawal
syndrome that develops within several hours to a few days after the cessation of (or re-
duction in) heavy and prolon ged alcohol use (Criteria A and B). The withdrawal syn-
drome includes two or more of the sympto ms reflecting autonomic hyperactivity and
anxiety listed in Criterion B, along with gastrointestinal symptoms.
Withdrawal symptoms cause clinically signific ant distress or impairment in social, oc-