F19.17
BillableOther psychoactive substance abuse with psychoactive substance-induced persisting dementia
HCC Category Mapping
What This Code Means
A condition where someone abuses multiple drugs and develops progressive cognitive decline and dementia-like symptoms that are caused by the substance use.
Coding Tips
- •Document cognitive domains affected (memory, executive function, language, etc.)
- •Differentiate from primary dementia by establishing the temporal relationship with substance abuse
Clinical Significance
This code identifies persisting dementia caused by other psychoactive substance exposure, representing irreversible neurotoxic brain damage. Substance-induced persisting dementia indicates permanent cognitive decline requiring long-term supportive care, cognitive rehabilitation, and ongoing supervision. Accurate documentation is essential for risk adjustment as these patients have substantially elevated care needs comparable to other dementia etiologies.
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
- ✓Cognitive assessment documenting persistent deficits in memory, executive function, or other cognitive domains
- ✓Provider documentation that the dementia is caused by substance use and persists beyond the period of acute intoxication or withdrawal
- ✓Assessment and plan addressing the substance use disorder with treatment approach documented