F10.159

HCC Category Mapping

What This Code Means

A person who abuses alcohol and experiences psychotic symptoms (such as delusions or hallucinations) from alcohol use, but the specific type of psychotic symptom is not documented.

Coding Tips

• •Use this code when psychotic disorder is present but hallucinations are not specifically documented
• •Query the provider if hallucinations are present, as F10.151 would be more specific

Clinical Significance

This code captures alcohol abuse with alcohol-induced psychotic disorder, unspecified, documenting a psychiatric manifestation directly caused by alcohol use. The distinction between substance-induced psychiatric symptoms and primary psychiatric disorders is clinically crucial for treatment planning — substance-induced conditions may resolve with sustained sobriety. These combination codes carry higher risk adjustment weight reflecting the dual complexity of substance use disorder combined with psychiatric comorbidity.

Documentation Requirements

• ✓Documentation of a maladaptive pattern of alcohol use with clinically significant impairment or distress (recurrent use causing role failure, hazardous use, legal problems, or social/interpersonal problems)
• ✓Confirmation that criteria for alcohol dependence are NOT met (no tolerance, withdrawal, or compulsive use pattern)
• ✓Documentation that the psychotic disorder, unspecified is directly attributable to alcohol use, not a primary/independent psychiatric disorder
• ✓Documentation of psychotic symptoms (delusions and/or hallucinations) and their temporal relationship to alcohol use
• ✓Assessment and plan addressing alcohol use disorder with treatment recommendations (counseling, medication-assisted treatment, referral, etc.)

Commonly Confused Codes