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F18.259 ICD-10-CM Code: Inhalant dependence with inhalant-induced psychotic disorder, unspecified

F18.259 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

ICD-10-CM Code View

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Code lookupF18.259

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

F18.259

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

Inhalant dependence with inhalant-induced psychotic disorder, unspecified

This code describes a person who is dependent on inhalant substances (like glue, paint thinner, or aerosols) and has developed a psychotic disorder as a result, but the specific type of psychotic symptoms is not specified. The psychotic symptoms may include hallucinations, delusions, or disorganized thinking caused by the inhalant use.

Buddy the Bee presenting code insight

Buddy Insight

Inhalant dependence with unspecified psychotic disorder captures substance-induced psychosis when the documentation does not clarify whether delusions or hallucinations predominate.

OverviewRisk ModelsCode BookDocumentationAuditNotesEdition comparison

CMS-HCC V28

HCC 135

Coefficient HCC 135: 0.424 (Community Non-Dual Aged (CNA))

CMS-HCC V24

Historical

Historical

Not used for CY2026 payment

ACA/HHS

HCC 081

Code-level coefficient reference

ESRD/PACE

HCC 54

Code-level coefficient reference

RXHCC

N/A

—

Not mapped

Code Book Path

Official
F18.2Inhalant dependenceF18.25Inhalant dependence with inhalant-induced psychotic disorderF18.259Inhalant dependence with inhalant-induced psychotic disorder, unspecified

Inclusion Terms

Official

No inclusion terms are included in this display for F18.259. 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
F18.250Inhalant dependence with inhalant-induced psychotic disorder with delusionsF18.251Inhalant dependence with inhalant-induced psychotic disorder with hallucinations

Includes

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

Excludes 1

Official
  • inhalant abuse (F18.1-)Inherited from F18.2
  • inhalant use, unspecified (F18.9-)Inherited from F18.2

Code First

Official

No Code First sequencing instructions are included in this display for F18.259. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for F18.259. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for F18.259. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance
Documentation of inhalant dependence with psychotic symptoms
Evidence of psychosis linked to inhalant use
Provider query for specific psychotic features
Mental status examination documenting psychotic symptoms

MEAT Support

HCC Buddy guidance
Documentation of inhalant dependence with psychotic symptoms
Evidence of psychosis linked to inhalant use
Provider query for specific psychotic features
Mental status examination documenting psychotic symptoms

Audit Caution

HCC Buddy guidance
Using F18.29 when psychosis IS present — loses HCC 54 capture
Not querying for specific psychotic features
Confusing psychosis with delirium
Missing the psychotic component altogether

Common Mistakes

HCC Buddy guidance
F18.250 — With delusions; preferred when delusions are documented
F18.251 — With hallucinations; preferred when hallucinations are documented
F18.29 — With unspecified induced disorder; does NOT capture psychosis and maps to lower HCC
F18.159 — Inhalant abuse with psychotic disorder, unspecified; use for abuse

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 F18.259 an HCC code?

Yes. F18.259 (Inhalant dependence with inhalant-induced psychotic disorder, unspecified) 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: F18.259 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
F18.259
Description
Inhalant dependence with inhalant-induced psychotic disorder, unspecified
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 F18.259 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for F18.259

For F18.259, 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

F18.259 is the ICD-10-CM diagnosis code for inhalant dependence with inhalant-induced psychotic disorder, unspecified. This code describes a person who is dependent on inhalant substances (like glue, paint thinner, or aerosols) and has developed a psychotic disorder as a result, but the specific type of psychotic symptoms is not specified. The psychotic symptoms may include hallucinations, delusions, or disorganized thinking caused by the inhalant use. F18.259 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, F18.259 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 F18.259; 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.

Verify documentation clearly states both inhalant dependence AND inhalant-induced psychotic disorder to justify this combination code; do not use if only one condition is present. For F18.259, 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 F18.259 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • •Verify documentation clearly states both inhalant dependence AND inhalant-induced psychotic disorder to justify this combination code; do not use if only one condition is present
  • •If the specific type of psychotic disorder is documented (such as with delusions or with hallucinations), use the more specific subcategories F18.251 or F18.252 instead of the unspecified code F18.259

Clinical Significance

Inhalant dependence with unspecified psychotic disorder captures substance-induced psychosis when the documentation does not clarify whether delusions or hallucinations predominate. Despite being unspecified, this still maps to HCC 54, the highest substance use category, making documentation of any psychotic features important.

Documentation Requirements

  • ✓Documentation of inhalant dependence with psychotic symptoms
  • ✓Evidence of psychosis linked to inhalant use
  • ✓Provider query for specific psychotic features
  • ✓Mental status examination documenting psychotic symptoms
  • ✓Differentiation from delirium and primary psychotic disorders

Commonly Confused Codes

  • •F18.250: With delusions; preferred when delusions are documented
  • •F18.251: With hallucinations; preferred when hallucinations are documented
  • •F18.29: With unspecified induced disorder; does NOT capture psychosis and maps to lower HCC
  • •F18.159: Inhalant abuse with psychotic disorder, unspecified; use for abuse

Child Codes

F18.250Inhalant dependence with inhalant-induced psychotic disorder with delusions
HCC 135
F18.251Inhalant dependence with inhalant-induced psychotic disorder with hallucinations
HCC 135
F18.259Inhalant dependence with inhalant-induced psychotic disorder, unspecified
HCC 135

Code Hierarchy

└F18Inhalant related disorders└F18.2Inhalant dependence└F18.25Inhalant dependence with inhalant-induced psychotic disorder└F18.259Inhalant dependence with inhalant-induced psychotic disorder, unspecified
└F18.259Inhalant dependence with inhalant-induced psychotic disorder, unspecified

Also searched as

  • F18 259
  • F18259

For F18.259, 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.

F18.259 maps to CMS-HCC V28 category 135, Drug Use with Psychotic Complications. See the ICD-10 to HCC mapping hub for how the V28 crosswalk works. The mapping identifies a payment HCC category for F18.259. Review its source-labeled HCC coefficient above, check the RAF Calculator with complete member context for CMS-HCC V28 PY2026, and confirm the documentation the chart needs before the code is submitted. HCC Buddy shows no RAF score unless every required source and calculation check passes.

Work F18.259 in HCC Buddy

Open F18.259 in the Code Book for the full Index-to-Tabular path, MEAT checklist, and V28 HCC mapping, or in the Encoder to code from a keyword search. Pro includes 7 days to try everything, no card required.

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