F16.121
BillableHallucinogen abuse with intoxication with delirium
HCC Category Mapping
V28HCC 137 — Drug Use Disorder/Substance Use Disorder, Moderate/Severe
0.358V24HCC 55 — Drug/Alcohol Dependence
0.334ESRDHCC 55 — Drug/Alcohol Dependence
0.000What This Code Means
Misuse of hallucinogenic drugs (like LSD or psilocybin) with acute confusion and disorientation during intoxication.
Coding Tips
- •This code requires documentation of both hallucinogen abuse and delirium as a specific manifestation of intoxication
- •Delirium must be present during the acute intoxication period, not as a separate condition
Clinical Significance
Hallucinogen abuse with intoxication delirium is a medical emergency where hallucinogenic drug use produces acute delirium with disorientation, confusion, and potential for dangerous behavior. This is more common with PCP-type hallucinogens but can occur with any hallucinogenic substance at high doses. Patients may require physical restraint, sedation, and intensive monitoring for safety.
Documentation Requirements
- ✓Documented hallucinogen abuse
- ✓Clinical evidence of acute intoxication from hallucinogens
- ✓Delirium criteria documented: acute onset confusion, altered consciousness, disorientation, fluctuating mental status
- ✓Specific hallucinogen identified when possible
- ✓Safety interventions, level of monitoring, and any restraint use documented
Commonly Confused Codes
F16.120 — Hallucinogen abuse with uncomplicated intoxication; no delirium presentF16.122 — Hallucinogen abuse with intoxication with perceptual disturbance; perceptual changes without full deliriumF05 — Delirium due to known physiological condition; non-substance-related deliriumF16.221 — Hallucinogen dependence with intoxication delirium; requires documented dependence
Code Hierarchy
└F16Hallucinogen related disorders└F16.1Hallucinogen abuse└F16.12Hallucinogen abuse with intoxication└F16.121Hallucinogen abuse with intoxication with delirium
└F16.121Hallucinogen abuse with intoxication with delirium