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F11.951

Billable

Opioid use, unspecified with opioid-induced psychotic disorder with hallucinations

HCC Category Mapping

V28HCC 135Drug/Alcohol Psychosis
0.000
V24HCC 54Drug/Alcohol Psychosis
0.434
ESRDHCC 54Drug/Alcohol Psychosis
0.000

What This Code Means

Seeing, hearing, or sensing things that aren't real as a direct result of opioid use, such as hearing voices or seeing shadows.

Coding Tips

  • Document the type of hallucinations (visual, auditory, tactile, olfactory, or gustatory)
  • Confirm temporal relationship between opioid use and hallucination onset

Clinical Significance

Opioid use, unspecified with opioid-induced psychotic disorder with hallucinations captures false sensory perceptions caused by opioid use in a patient whose use pattern is not classified. This is a severe psychiatric emergency requiring immediate evaluation, differentiation from primary psychotic disorders, and assessment for overdose or poly-substance use.

Documentation Requirements

  • Documentation of specific hallucination types (visual, auditory, tactile, olfactory, gustatory)
  • Provider statement that hallucinations are opioid-induced
  • Temporal relationship between opioid use and hallucination onset
  • Mental status examination documenting psychotic features
  • Assessment ruling out primary psychotic disorders, delirium, and other medical causes
  • Documentation of opioid use (though pattern not classified)
  • Safety assessment and treatment plan

Commonly Confused Codes

Code Hierarchy

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