F16.251
BillableHallucinogen dependence 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
A person dependent on hallucinogenic drugs is experiencing psychosis with hallucinations (seeing or hearing things that aren't real) caused by the hallucinogen use.
Coding Tips
- •This code specifies that hallucinations are present; use F16.259 if psychosis is present without specifying hallucinations
- •Document the type of hallucinations (visual, auditory, tactile) and their relationship to hallucinogen use
Clinical Significance
Hallucinogen dependence with psychotic disorder featuring hallucinations captures active perceptual disturbances (visual, auditory, or tactile) caused by hallucinogen dependence. This can persist as hallucinogen persisting psychosis and requires psychiatric evaluation, possible antipsychotic therapy, and safety precautions.
Documentation Requirements
- ✓Documentation of hallucinogen dependence
- ✓Specific documentation of hallucinations (visual, auditory, or other sensory modalities)
- ✓Provider statement that hallucinations are induced by hallucinogen use
- ✓Mental status examination documenting hallucination type and content
- ✓Distinction from hallucinogen persisting perception disorder (flashbacks, F16.283) which is a separate condition
- ✓Assessment of insight — does the patient recognize hallucinations as substance-induced?
Commonly Confused Codes
F16.250 — Hallucinogen dependence with psychotic disorder with delusions; delusions are false beliefs, not perceptual disturbancesF16.283 — Hallucinogen dependence with persisting perception disorder (flashbacks); flashbacks are re-experiences, not active psychosisF16.259 — Hallucinogen dependence with psychotic disorder, unspecified; use only when type cannot be determinedF16.151 — Hallucinogen abuse with psychotic disorder with hallucinations; use when abuse not dependence is documented
Code Hierarchy
└F16Hallucinogen related disorders└F16.2Hallucinogen dependence└F16.25Hallucinogen dependence with hallucinogen-induced psychotic disorder└F16.251Hallucinogen dependence with hallucinogen-induced psychotic disorder with hallucinations
└F16.251Hallucinogen dependence with hallucinogen-induced psychotic disorder with hallucinations