F16.151
BillableHallucinogen abuse with hallucinogen-induced psychotic disorder with hallucinations
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
Misuse of hallucinogenic drugs leading to a persistent psychotic disorder characterized by false perceptions or sensations (hallucinations).
Coding Tips
- •Distinguish between acute intoxication-related hallucinations (F16.122) and persistent psychotic hallucinations
- •Document the duration and persistence of hallucinations beyond the expected intoxication period
Clinical Significance
Hallucinogen abuse with hallucinogen-induced psychotic disorder with hallucinations represents a severe complication where persistent hallucinations develop beyond the expected duration of hallucinogenic drug effects. While hallucinations during intoxication are expected with hallucinogens, this code captures cases where hallucinations persist and constitute a true psychotic disorder requiring psychiatric intervention. This carries the highest risk adjustment weight in the substance use hierarchy.
Documentation Requirements
- ✓Documented hallucinogen abuse pattern
- ✓Hallucinations described with type (visual, auditory, tactile) that persist beyond acute intoxication
- ✓Documentation distinguishing persistent psychotic hallucinations from expected intoxication effects
- ✓Temporal relationship between hallucinogen use and onset of persistent hallucinations
- ✓Psychiatric evaluation and treatment plan for psychotic symptoms
Commonly Confused Codes
F16.122 — Hallucinogen abuse with intoxication with perceptual disturbance; transient effects during intoxication onlyF16.183 — Hallucinogen persisting perception disorder (flashbacks); recurrent brief perceptual experiences, not persistent psychosisF16.150 — Hallucinogen abuse with psychotic disorder with delusions; delusions vs. hallucinationsF20.9 — Schizophrenia, unspecified; primary psychotic disorder
Code Hierarchy
└F16Hallucinogen related disorders└F16.1Hallucinogen abuse└F16.15Hallucinogen abuse with hallucinogen-induced psychotic disorder└F16.151Hallucinogen abuse with hallucinogen-induced psychotic disorder with hallucinations
└F16.151Hallucinogen abuse with hallucinogen-induced psychotic disorder with hallucinations