F19.229
BillableOther psychoactive substance dependence with intoxication, unspecified
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, but the specific type or severity of intoxication is not specified.
Coding Tips
- •Use only when intoxication status is documented but specific complications are unclear
- •Query provider for clarification on intoxication severity when possible
Clinical Significance
This code captures other psychoactive substance intoxication where the severity and specific complications are not documented. Even unspecified intoxication indicates active substance use requiring clinical assessment and potential intervention. Coders should query for more specificity when possible, as the complication level affects HCC mapping.
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
- ✓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) — use when documentation confirms no delirium or perceptual disturbancesF19.221 (Intoxication delirium) — use when delirium symptoms are explicitly documentedF10-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└F19.229Other psychoactive substance dependence with intoxication, unspecified
└F19.229Other psychoactive substance dependence with intoxication, unspecified