F16.959
BillableHallucinogen use, unspecified with hallucinogen-induced psychotic disorder, unspecified
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 uses hallucinogenic drugs and experiences psychotic symptoms caused by the hallucinogen, but the specific type is not detailed.
Coding Tips
- •Use this code when psychotic disorder is present but specific features are not documented
- •Query provider to identify whether hallucinations, delusions, or other psychotic features are present
Clinical Significance
This unspecified psychotic disorder code for hallucinogen use captures psychosis without detailing whether delusions or hallucinations are present. Despite the lack of specificity, it still maps to the higher-value psychosis HCC, but should prompt documentation improvement efforts.
Documentation Requirements
- ✓Documentation of hallucinogen use with psychotic symptoms
- ✓Provider query for specific psychotic features
- ✓Mental status examination findings supporting psychosis
- ✓Differentiation from non-psychotic induced disorders
- ✓Treatment plan for psychotic symptoms
Commonly Confused Codes
F16.950 — With delusions; preferred when delusions are documentedF16.951 — With hallucinations; preferred when hallucinations are documentedF16.99 — Hallucinogen use, unspecified with unspecified induced disorder; does NOT capture psychosis and maps to lower HCCF16.259 — Hallucinogen dependence with psychotic disorder, unspecified; more specific regarding dependence
Code Hierarchy
└F16Hallucinogen related disorders└F16.9Hallucinogen use, unspecified└F16.95Hallucinogen use, unspecified with hallucinogen-induced psychotic disorder└F16.959Hallucinogen use, unspecified with hallucinogen-induced psychotic disorder, unspecified
└F16.959Hallucinogen use, unspecified with hallucinogen-induced psychotic disorder, unspecified