F16.20
BillableHallucinogen dependence, uncomplicated
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
A person is dependent on hallucinogenic drugs (like LSD or psilocybin) without any additional complications or symptoms beyond the dependence itself.
Coding Tips
- •Use this code when hallucinogen dependence is documented without intoxication, withdrawal, or other specified conditions
- •This is the base code for uncomplicated hallucinogen dependence; check for any complicating factors that would require a more specific code
Clinical Significance
Hallucinogen dependence represents a more severe clinical state than abuse, indicating the patient has developed tolerance, withdrawal symptoms, or compulsive use patterns. This code signals higher resource utilization needs including structured treatment programs, counseling, and ongoing monitoring for relapse and medical complications.
Documentation Requirements
- ✓Provider documentation explicitly using the term 'dependence' (not just 'use' or 'abuse')
- ✓Evidence of dependence criteria: tolerance, withdrawal, compulsive use, or inability to stop
- ✓Type of hallucinogen when known
- ✓Statement that the dependence is uncomplicated (no current intoxication, withdrawal, or induced disorders)
- ✓Current treatment plan including any medication-assisted treatment or counseling referrals
Commonly Confused Codes
F16.10 — Hallucinogen abuse, uncomplicated; abuse is a less severe pattern than dependenceF16.21 — Hallucinogen dependence, in remission; use when the patient has achieved sustained abstinenceF16.220 — Hallucinogen dependence with intoxication, uncomplicated; use when currently intoxicatedF16.90 — Hallucinogen use, unspecified, uncomplicated; use only when abuse vs dependence is undetermined
Code Hierarchy
└F16Hallucinogen related disorders└F16.2Hallucinogen dependence└F16.20Hallucinogen dependence, uncomplicated
└F16.20Hallucinogen dependence, uncomplicated