F19.921
BillableOther psychoactive substance use, unspecified with intoxication with 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
Current use of various psychoactive substances causing intoxication with confusion, disorientation, or altered mental state.
Coding Tips
- •Use this code when intoxication is accompanied by delirium (confusion, disorientation, hallucinations)
- •This represents a more severe presentation requiring closer monitoring
Clinical Significance
Other psychoactive substance use, unspecified with intoxication with delirium represents a serious acute presentation where substance intoxication has caused an altered mental state with confusion, disorientation, and possible agitation. Delirium during intoxication is a medical emergency requiring intensive monitoring and often inpatient care. This diagnosis significantly impacts risk adjustment by reflecting the acute severity and high resource utilization associated with these presentations.
Documentation Requirements
- ✓Documentation of active intoxication from psychoactive substance(s)
- ✓Clinical assessment confirming delirium (altered consciousness, disorientation, cognitive disturbance, acute onset)
- ✓Use of validated delirium assessment tool (CAM, CAM-ICU) when available
- ✓Identification of the substance(s) causing intoxication when possible
- ✓Assessment that the delirium is directly caused by the substance intoxication, not an underlying medical condition
- ✓Monitoring plan and level of care required
Commonly Confused Codes
F19.920 — Intoxication WITHOUT delirium; ensure delirium criteria are documented before using F19.921F19.922 — Intoxication with PERCEPTUAL DISTURBANCE (hallucinations without full delirium); different clinical pictureF19.931 — WITHDRAWAL delirium is a different clinical scenario from intoxication deliriumF05 — Delirium due to known physiological condition; use when delirium is from a medical cause, not substance intoxicationR41.0 — Disorientation, unspecified; this symptom code should not be used when delirium diagnosis is documented
Code Hierarchy
└F19Other psychoactive substance related disorders└F19.9Other psychoactive substance use, unspecified└F19.92Other psychoactive substance use, unspecified with intoxication└F19.921Other psychoactive substance use, unspecified with intoxication with delirium
└F19.921Other psychoactive substance use, unspecified with intoxication with delirium