F16.250
BillableHallucinogen dependence with hallucinogen-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 hallucinogenic drugs (like LSD or psilocybin) and is experiencing a mental health condition where they have false beliefs (delusions) caused by the hallucinogen use. This represents both the addiction and the psychiatric symptoms occurring together.
Coding Tips
- •This code requires documentation of both the hallucinogen dependence AND the hallucinogen-induced psychotic disorder with delusions to be present; do not use this code if only one condition exists
- •The fifth character '0' indicates the current episode is not in remission; if the patient is in early remission or sustained remission, use F16.251 or F16.252 respectively
Clinical Significance
This code captures the highest-severity hallucinogen dependence presentation — dependence combined with substance-induced psychotic disorder featuring delusions. Delusions from hallucinogen use can persist beyond intoxication and may require antipsychotic treatment, psychiatric hospitalization, and long-term monitoring for chronic psychotic features.
Documentation Requirements
- ✓Documentation of hallucinogen dependence
- ✓Specific documentation of delusions (false fixed beliefs) as the psychotic feature
- ✓Provider statement linking the psychotic disorder to hallucinogen use
- ✓Mental status examination documenting delusional content and type
- ✓Differentiation from primary psychotic disorders (schizophrenia, delusional disorder)
- ✓Treatment plan addressing both dependence and psychotic symptoms
Commonly Confused Codes
F16.251 — Hallucinogen dependence with psychotic disorder with hallucinations; use when hallucinations predominate over delusionsF16.259 — Hallucinogen dependence with psychotic disorder, unspecified; less specific regarding psychotic featuresF16.150 — Hallucinogen abuse with psychotic disorder with delusions; use when abuse rather than dependenceF20.0 — Paranoid schizophrenia; use for primary psychotic disorder not induced by substance use
Code Hierarchy
└F16Hallucinogen related disorders└F16.2Hallucinogen dependence└F16.25Hallucinogen dependence with hallucinogen-induced psychotic disorder└F16.250Hallucinogen dependence with hallucinogen-induced psychotic disorder with delusions
└F16.250Hallucinogen dependence with hallucinogen-induced psychotic disorder with delusions