F19.151
BillableOther psychoactive substance abuse with psychoactive substance-induced psychotic disorder with hallucinations
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 condition where someone abuses various drugs and experiences false sensory perceptions (seeing, hearing, or feeling things that aren't there) caused by the substance use.
Coding Tips
- •Document the specific type of hallucinations (visual, auditory, tactile, olfactory, gustatory)
- •Distinguish between substance-induced hallucinations and hallucinations from other psychiatric conditions
Clinical Significance
This code captures substance-induced psychotic disorder, which represents a serious psychiatric complication of other psychoactive substance abuse. 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 specifying the psychoactive substance(s) involved (e.g., designer drugs, bath salts, kratom, polysubstance use)
- ✓Clinical documentation supporting substance abuse pattern (maladaptive use pattern causing clinically significant impairment) without meeting criteria for dependence
- ✓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
F19.20-F19.29 (Other psychoactive substance dependence) — dependence indicates a more severe pattern with tolerance, compulsive use, or withdrawal; abuse is a less severe use patternF19.90-F19.99 (Other psychoactive substance use, unspecified) — unspecified use is used when abuse vs. dependence is not documentedF19.150 (Psychotic disorder with delusions) — delusions are fixed false beliefs; hallucinations are false sensory perceptionsF20-F29 (Schizophrenia spectrum disorders) — primary psychotic disorders are not substance-induced; confirm temporal relationship with substance useF10-F16 (Specific substance codes: alcohol, opioids, cannabis, sedatives, cocaine, stimulants) — use substance-specific codes when the substance is identified; F19 is for 'other' or multiple unspecified substances
Code Hierarchy
└F19Other psychoactive substance related disorders└F19.1Other psychoactive substance abuse└F19.15Other psychoactive substance abuse with psychoactive substance-induced psychotic disorder└F19.151Other psychoactive substance abuse with psychoactive substance-induced psychotic disorder with hallucinations
└F19.151Other psychoactive substance abuse with psychoactive substance-induced psychotic disorder with hallucinations