F19.920

HCC Category Mapping

What This Code Means

Current use of various psychoactive substances with intoxication symptoms but without severe complications.

Coding Tips

• •This code indicates active intoxication from unspecified psychoactive substances without delirium or perceptual disturbances
• •Document the specific substance if possible to use a more specific code

Clinical Significance

Other psychoactive substance use, unspecified with intoxication, uncomplicated represents a patient currently under the influence of a psychoactive substance without meeting criteria for abuse or dependence, and without severe complications like delirium. This code is important in risk adjustment because it captures substance use disorders that still require monitoring and intervention. The 'unspecified' use pattern often represents an opportunity for provider education on documenting the severity of substance use.

Documentation Requirements

• ✓Documentation of current substance use (not just historical use)
• ✓Evidence of intoxication at the time of evaluation (clinical signs, lab results, patient report)
• ✓Absence of delirium or perceptual disturbances to support 'uncomplicated' designation
• ✓Identification of the substance(s) used when possible
• ✓Assessment of whether use meets criteria for abuse or dependence
• ✓Clinical evaluation of the intoxication severity

Commonly Confused Codes