What is ICD-10 code F18.151?

F18.151 is the ICD-10-CM diagnosis code for Inhalant abuse with inhalant-induced psychotic disorder with hallucinations. A person is abusing inhalants and is experiencing psychosis with hallucinations (seeing, hearing, or sensing things that aren't real) caused by the inhalant use. F18.151 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. F18.151 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. F18.151 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. F18.151 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Which HCC does F18.151 map to under V28?

F18.151 maps to CMS-HCC V28 HCC 135 (Drug Use with Psychotic Complications). The category numbers, labels, and conditions come from the CMS-HCC V28 model file for payment year 2026.

2026 ICD-10-CM F18.151: Inhalant abuse

F18.151 maps to CMS-HCC V28 135. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · HCC Buddy coding tools

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Code lookupF18.151

Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Mental, Behavioral and Neurodevelopmental disorders (F01-F99) / Mental and behavioral disorders due to psychoactive substance use (F10-F19)

F18.151

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Inhalant abuse with inhalant-induced psychotic disorder with hallucinations

A person is abusing inhalants and is experiencing psychosis with hallucinations (seeing, hearing, or sensing things that aren't real) caused by the inhalant use.

Buddy Insight

Inhalant abuse with induced psychotic disorder with hallucinations captures patients experiencing visual, auditory, or tactile hallucinations caused by inhalant neurotoxicity.

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

Mapped

HCC 135

Drug Use with Psychotic Compl...

Code-level coefficient reference

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

Mapped

HCC 081

HHS-HCC 081 adult, RAF varies...

Code-level coefficient reference

ESRD/PACE

Mapped

HCC 54

Substance Use with Psychotic ...

Code-level coefficient reference

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

F18.1Inhalant abuse F18.15Inhalant abuse with inhalant-induced psychotic disorder F18.151Inhalant abuse with inhalant-induced psychotic disorder with hallucinations

Inclusion Terms

Official

No inclusion terms are included in this display for F18.151. Check the code and parent instructions in the Code Book.

Excludes 2

Official

symptoms, signs and abnormal clinical laboratory findings, not elsewhere classified (R00-R99)Inherited from F01-F99

Related Codes

Official

F18.150Inhalant abuse with inhalant-induced psychotic disorder with delusions F18.159Inhalant abuse with inhalant-induced psychotic disorder, unspecified

Includes

Official

disorders of psychological developmentInherited from F01-F99, F18
volatile solventsInherited from F01-F99, F18

Excludes 1

Official

inhalant dependence (F18.2-)Inherited from F18.1
inhalant use, unspecified (F18.9-)Inherited from F18.1

Code First

Official

No Code First sequencing instructions are included in this display for F18.151. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for F18.151. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for F18.151. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Documentation of inhalant abuse

Type of hallucinations specified (visual, auditory, tactile — visual most common with inhalants)

Provider statement linking hallucinations to inhalant use

Mental status examination documenting hallucinations

MEAT Support

HCC Buddy guidance

Documentation of inhalant abuse

Type of hallucinations specified (visual, auditory, tactile — visual most common with inhalants)

Provider statement linking hallucinations to inhalant use

Mental status examination documenting hallucinations

Audit Caution

HCC Buddy guidance

Confusing intoxication-related perceptual disturbances with psychotic hallucinations

Coding delirium when the primary feature is hallucinations without consciousness changes

Not specifying the hallucination type when it is documented

Missing the psychotic disorder diagnosis and coding only abuse — loses HCC 54 capture

Common Mistakes

HCC Buddy guidance

F18.150 — With delusions; delusions are false beliefs, hallucinations are false perceptions

F18.121 — Inhalant abuse with intoxication delirium; delirium has altered consciousness

F18.251 — Inhalant dependence with psychotic disorder with hallucinations; use for dependence

F18.159 — Unspecified psychotic disorder; less specific about psychotic features

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is F18.151 an HCC code?

Yes. F18.151 (Inhalant abuse with inhalant-induced psychotic disorder with hallucinations) maps to HCC 135, Drug Use with Psychotic Complications under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.424. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.

Coder answer: F18.151 is billable and maps to V28 HCC 135, Drug Use with Psychotic Complications. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code: F18.151
Description: Inhalant abuse with inhalant-induced psychotic disorder with hallucinations
HCC (V28): HCC 135 — Drug Use with Psychotic Complications
RAF reference coefficient: 0.424
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 135, Drug Use with Psychotic Complications

0.424

ESRDHCC 54, Substance Use with Psychotic Complications

Not separately weighted

These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. Weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.

Work F18.151 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for F18.151

For F18.151, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.

MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
EEvaluate: test results, medication response, or physical findings reviewed by the provider
AAssess: explicit mention in the assessment or plan with acknowledgment of status
TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis

Coder workflow notes

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What This Code Means

F18.151 is the ICD-10-CM diagnosis code for inhalant abuse with inhalant-induced psychotic disorder with hallucinations. A person is abusing inhalants and is experiencing psychosis with hallucinations (seeing, hearing, or sensing things that aren't real) caused by the inhalant use. F18.151 sits in the ICD-10-CM chapter for mental, behavioral and neurodevelopmental disorders (f01-f99), within the section covering mental and behavioral disorders due to psychoactive substance use (f10-f19).

Under the CMS-HCC V28 risk adjustment model, F18.151 maps to Drug Use with Psychotic Complications (HCC 135) with a source-labeled community, non-dual, aged reference coefficient of 0.424. No V24 mapping is shown for F18.151; use the applicable model and payment year when reviewing the V28 mapping. For CY2026 non-PACE Medicare Advantage, CMS uses 100% of the 2024 CMS-HCC model (V28). PACE uses a separate model blend. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.

Document the specific type of hallucinations (visual, auditory, tactile) when possible. For F18.151, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for F18.151 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Document the specific type of hallucinations (visual, auditory, tactile) when possible
•This represents a serious psychiatric complication requiring immediate clinical attention

Clinical Significance

Inhalant abuse with induced psychotic disorder with hallucinations captures patients experiencing visual, auditory, or tactile hallucinations caused by inhalant neurotoxicity. Toluene and other volatile solvents are particularly associated with hallucinations. This maps to the higher psychosis HCC and indicates severe clinical complications.

Documentation Requirements

✓Documentation of inhalant abuse
✓Type of hallucinations specified (visual, auditory, tactile — visual most common with inhalants)
✓Provider statement linking hallucinations to inhalant use
✓Mental status examination documenting hallucinations
✓Assessment of insight — does the patient recognize hallucinations as abnormal
✓Neurological examination and brain imaging considerations

Commonly Confused Codes

•F18.150: With delusions; delusions are false beliefs, hallucinations are false perceptions
•F18.121: Inhalant abuse with intoxication delirium; delirium has altered consciousness
•F18.251: Inhalant dependence with psychotic disorder with hallucinations; use for dependence
•F18.159: Unspecified psychotic disorder; less specific about psychotic features