F16.10
BillableHallucinogen abuse, uncomplicated
HCC Category Mapping
V28HCC 138 — Drug Use Disorder/Substance Use Disorder, Mild
0.476V24HCC 56 — Drug/Alcohol Abuse, Without Dependence
0.000ESRDHCC 56 — Drug/Alcohol Abuse, Without Dependence
0.000What This Code Means
A condition where someone abuses hallucinogenic drugs (like LSD or psilocybin) without current complications or withdrawal symptoms.
Coding Tips
- •This code indicates abuse (harmful use) rather than dependence; the distinction is important for treatment planning
- •Document the specific hallucinogen being abused if identifiable
Clinical Significance
Hallucinogen abuse, uncomplicated, captures the harmful pattern of hallucinogenic drug use (LSD, psilocybin, mescaline, DMT) without current complications. While hallucinogens have a lower physical dependence profile than other substances, they carry significant psychiatric risks including persistent perceptual disorders and triggered psychotic episodes. This diagnosis is important for risk stratification and monitoring for potential psychiatric complications.
Documentation Requirements
- ✓Documented pattern of hallucinogen abuse meeting clinical criteria for harmful use
- ✓Specific hallucinogen identified when possible (LSD, psilocybin, phencyclidine, etc.)
- ✓Note: PCP is coded under F16 only for non-PCP hallucinogens; PCP has separate codes (F16.1x series includes 'other hallucinogen' — verify substance type)
- ✓Absence of current intoxication, withdrawal, or other complications
- ✓Impact on social, occupational, or other important areas of functioning
Commonly Confused Codes
F16.11 — Hallucinogen abuse, in remission; use when abuse is no longer activeF16.20 — Hallucinogen dependence, uncomplicated; more severe, requiring documented dependence criteriaF16.120 — Hallucinogen abuse with intoxication; use when currently intoxicatedF19.10 — Other psychoactive substance abuse, uncomplicated; use for substances not specifically classifiedF16.10 is for 'other hallucinogen' — ensure PCP/phencyclidine is coded under the correct subcategory if applicable
Code Hierarchy
└F16Hallucinogen related disorders└F16.1Hallucinogen abuse└F16.10Hallucinogen abuse, uncomplicated
└F16.10Hallucinogen abuse, uncomplicated