F18.951

HCC Category Mapping

What This Code Means

This code describes a person who uses inhalants (such as glue, paint thinner, or other volatile substances) and is experiencing psychotic symptoms, specifically hallucinations (seeing or hearing things that aren't real). The 'unspecified' part means the documentation doesn't indicate whether the use is occasional or habitual.

Coding Tips

• •Verify that the psychotic symptoms with hallucinations are documented as directly related to inhalant use rather than a separate primary psychotic disorder
• •Ensure the medical record specifies the type of inhalant being used if possible; if not documented, 'unspecified' is appropriate, but query the provider if additional detail is available

Clinical Significance

This code captures substance-induced psychotic disorder, which represents a serious psychiatric complication of inhalant use. Substance-induced psychosis significantly increases healthcare utilization, emergency department visits, and hospitalization risk, making accurate capture critical for risk adjustment. These patients require intensive psychiatric management and close monitoring for progression to chronic psychotic disorders.

Documentation Requirements

• ✓Provider documentation of inhalant use, specifying the type of inhalant when known (e.g., toluene, gasoline, aerosol propellants, nitrites)
• ✓Documentation of substance use pattern; query provider to determine if abuse or dependence criteria are met for more specific coding
• ✓Documentation of hallucinations (visual, auditory, tactile) that developed during or shortly after substance use, with the provider confirming they are substance-induced
• ✓Assessment and plan addressing the substance use disorder with treatment approach documented

Commonly Confused Codes