F18.221
BillableInhalant dependence with intoxication delirium
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 who is dependent on inhalants and is currently intoxicated with severe confusion, disorientation, and altered mental status (delirium) as a result.
Coding Tips
- •Delirium indicates a more severe presentation requiring urgent medical attention
- •Document specific delirium symptoms such as confusion, hallucinations, or disorientation
Clinical Significance
Inhalant dependence with intoxication delirium is a critical medical emergency. The combination of dependence (indicating chronic heavy use) with delirium (altered consciousness) signals severe neurotoxicity and risk of fatal cardiac arrhythmia, seizures, respiratory arrest, or aspiration. Immediate ICU-level care may be required.
Documentation Requirements
- ✓Documentation of inhalant dependence
- ✓Clinical evidence of delirium: acute confusion, fluctuating consciousness, disorientation
- ✓Cardiac monitoring and ECG results
- ✓Neurological assessment including GCS
- ✓Type of inhalant when identifiable
- ✓Emergency interventions and stabilization documented
- ✓Differential diagnosis ruling out other delirium causes
Commonly Confused Codes
F18.220 — With intoxication, uncomplicated; use when NO delirium is presentF18.229 — With intoxication, unspecified; use only when delirium status unknownF18.250 — With psychotic disorder with delusions; psychosis maintains consciousness, delirium does notF18.121 — Inhalant abuse with intoxication delirium; use when abuse rather than dependence