F19.221
BillableOther psychoactive substance 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 psychoactive substances and is currently intoxicated with severe confusion and disorientation (delirium).
Coding Tips
- •Document specific delirium symptoms (confusion, hallucinations, agitation) in the record
- •Note the timeline of symptom onset relative to substance use
Clinical Significance
This code identifies intoxication delirium from other psychoactive substance dependence, a severe acute presentation with altered consciousness, disorientation, and potential for dangerous behavior. Intoxication delirium often requires emergency department evaluation and potential hospitalization for medical stabilization. Capturing this code accurately reflects the elevated acuity and resource intensity of these encounters.
Documentation Requirements
- ✓Provider documentation specifying the psychoactive substance(s) involved (e.g., designer drugs, bath salts, kratom, polysubstance use)
- ✓Clinical documentation supporting dependence criteria: tolerance, withdrawal symptoms, compulsive use despite harm, or inability to control use
- ✓Documentation of acute intoxication state with signs and symptoms present at the time of encounter
- ✓Clinical findings supporting delirium: acute onset of confusion, fluctuating consciousness, disorientation, and cognitive disturbance temporally related to substance intoxication
- ✓Assessment and plan addressing the substance use disorder with treatment approach documented
Commonly Confused Codes
F19.10-F19.19 (Other psychoactive substance abuse) — abuse indicates a less severe use pattern without meeting dependence criteriaF19.90-F19.99 (Other psychoactive substance use, unspecified) — unspecified use is used when the severity of the use disorder is not documentedF19.220 (Intoxication, uncomplicated) — uncomplicated intoxication lacks the delirium features of acute confusion and altered consciousnessF19.222 (Intoxication with perceptual disturbance) — perceptual disturbance involves hallucinations with intact reality testing, not the global cognitive disruption of deliriumF10-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└F19.2Other psychoactive substance dependence└F19.22Other psychoactive substance dependence with intoxication└F19.221Other psychoactive substance dependence with intoxication delirium
└F19.221Other psychoactive substance dependence with intoxication delirium