F19.26

HCC Category Mapping

What This Code Means

This code describes a condition where a person is dependent on drugs or substances (other than alcohol, opioids, cannabis, stimulants, hallucinogens, or inhalants) and has developed lasting memory problems as a direct result of that substance use. The memory damage persists even when the person is not actively using the substance.

Coding Tips

• •Use this code only when both substance dependence AND persisting amnestic disorder are documented; the amnestic disorder must be specifically attributed to the substance use
• •The 'F19' category is for 'other psychoactive substances' - verify the specific substance is not better classified under F10-F18 (alcohol, opioids, cannabis, stimulants, hallucinogens, inhalants, or sedatives)

Clinical Significance

This code captures substance-induced persisting amnestic disorder, a severe and lasting memory impairment caused by other psychoactive substance dependence. This condition indicates significant neurotoxic damage that persists beyond the period of active substance use and requires ongoing neuropsychological monitoring. These patients have elevated care needs due to functional impairment from memory deficits.

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
• ✓Neuropsychological or clinical assessment documenting persistent memory impairment, particularly anterograde amnesia
• ✓Provider documentation establishing the amnestic disorder persists beyond intoxication or withdrawal and is directly caused by the substance
• ✓Assessment and plan addressing the substance use disorder with treatment approach documented

Commonly Confused Codes