F11.250

Billable

Opioid dependence with opioid-induced psychotic disorder with delusions

HCC Category Mapping

V28HCC 135 — Drug/Alcohol Psychosis

0.000

V24HCC 54 — Drug/Alcohol Psychosis

0.434

ESRDHCC 54 — Drug/Alcohol Psychosis

0.000

What This Code Means

A person is dependent on opioids and experiences psychotic symptoms, specifically false beliefs (delusions) caused by the opioid use.

Coding Tips

•Document the specific type of delusions present (paranoid, grandiose, somatic, etc.) in the medical record
•This represents a serious psychiatric complication of opioid dependence requiring mental health intervention

Clinical Significance

Opioid dependence with opioid-induced psychotic disorder with delusions is a severe psychiatric complication where chronic opioid dependence causes fixed false beliefs. This represents the most severe end of opioid-induced psychiatric morbidity and requires intensive dual-diagnosis treatment addressing both the addiction and the psychotic symptoms.

Documentation Requirements

✓Provider documentation of opioid dependence
✓Documentation of specific delusions (content, type: paranoid, grandiose, persecutory)
✓Statement that the psychotic disorder is opioid-induced
✓Temporal relationship between opioid use and delusional onset
✓Mental status examination documenting delusional content
✓Assessment ruling out primary psychotic disorders (schizophrenia, delusional disorder)
✓Safety assessment and dual-diagnosis treatment plan

Commonly Confused Codes

F11.251 — Opioid dependence with psychotic disorder with hallucinations: use when hallucinations (not delusions) are the primary feature F11.259 — Opioid dependence with psychotic disorder, unspecified: use when the psychosis type is not specified F11.150 — Opioid abuse with psychotic disorder with delusions: use when abuse (not dependence) is documented F22 — Delusional disorder: use when delusions are NOT substance-induced

Code Hierarchy

└F11.250Opioid dependence with opioid-induced psychotic disorder with delusions