F14.250
BillableCocaine dependence with cocaine-induced psychotic disorder with delusions
HCC Category Mapping
V28HCC 135 — Drug/Alcohol Psychosis
0.000V24HCC 54 — Drug/Alcohol Psychosis
0.434ESRDHCC 54 — Drug/Alcohol Psychosis
0.000What This Code Means
A person is dependent on cocaine and is experiencing psychosis with delusions (false beliefs) caused by the cocaine use.
Coding Tips
- •Document the specific nature of delusions (paranoid, grandiose, etc.) when possible
- •Distinguish between cocaine-induced psychosis and primary psychotic disorders in the medical record
Clinical Significance
Cocaine dependence with cocaine-induced psychotic disorder with delusions is a high-acuity condition where a cocaine-dependent patient develops fixed false beliefs directly caused by cocaine use. Cocaine-induced paranoid delusions are particularly common and can lead to violent behavior, resistance to treatment, and psychiatric hospitalization. This represents the most severe end of the cocaine-related mental health spectrum and requires aggressive psychiatric intervention alongside substance use treatment.
Documentation Requirements
- ✓Provider documentation of cocaine dependence
- ✓Clear documentation that the psychotic disorder is cocaine-induced
- ✓Specific description of delusions (paranoid, grandiose, referential, persecutory)
- ✓Mental status examination documenting delusional thinking
- ✓Documentation ruling out primary psychotic disorders (Schizophrenia, Schizoaffective Disorder)
- ✓Temporal relationship between cocaine use and delusion onset
- ✓Safety assessment and risk evaluation
- ✓Treatment plan including antipsychotic considerations
Commonly Confused Codes
F14.251 — Cocaine dependence with cocaine-induced psychotic disorder with hallucinations: use when hallucinations are the primary psychotic symptomF14.259 — Cocaine dependence with cocaine-induced psychotic disorder, unspecified: use when the type of psychosis is not specifiedF14.150 — Cocaine abuse with cocaine-induced psychotic disorder with delusions: use when the pattern is abuseF14.222 — Cocaine dependence with intoxication with perceptual disturbance: use for transient perceptual changes not meeting psychosis criteriaF22 — Delusional disorders: use only when delusions are primary, not substance-induced