F19.950

Billable

Other psychoactive substance use, unspecified with psychoactive substance-induced psychotic disorder with delusions

HCC Category Mapping

V28HCC 135 — Drug/Alcohol Psychosis

0.000

V24HCC 54 — Drug/Alcohol Psychosis

0.434

ESRDHCC 54 — Drug/Alcohol Psychosis

0.000

What This Code Means

A psychotic condition characterized by false beliefs (delusions) that develops directly from the use of various psychoactive substances.

Coding Tips

•Distinguish between substance-induced psychosis and primary psychotic disorders
•Document the timeline showing substance use preceded the psychotic symptoms

Clinical Significance

Other psychoactive substance use, unspecified with substance-induced psychotic disorder with delusions represents a serious psychiatric presentation where substance use has triggered false, fixed beliefs (delusions). This is a high-acuity condition requiring psychiatric intervention and often inpatient care. Accurate capture is critical for risk adjustment because substance-induced psychotic disorders map to a higher HCC than substance dependence alone, reflecting the significantly greater treatment burden.

Documentation Requirements

✓Documentation of psychoactive substance use temporally related to psychotic onset
✓Description of the specific delusions (persecutory, grandiose, referential, etc.)
✓Provider determination that psychosis is substance-induced rather than a primary psychotic disorder
✓Evidence that psychotic symptoms developed during or shortly after substance intoxication or withdrawal
✓Assessment of the patient's danger to self or others
✓Psychiatric evaluation and treatment plan including antipsychotic medication if indicated

Commonly Confused Codes

F19.951 — Substance-induced psychotic disorder with HALLUCINATIONS, not delusions; key distinction in symptom type F22 — Delusional disorder is a primary psychotic condition, not substance-induced F20.0 — Paranoid schizophrenia has persistent psychosis beyond substance use periods F19.921 — Intoxication with delirium may include delusion-like symptoms but is a different diagnosis F19.150/F19.250 — Use these for substance ABUSE or DEPENDENCE with induced psychosis with delusions

Code Hierarchy

└F19Other psychoactive substance related disorders └F19.9Other psychoactive substance use, unspecified └F19.95Other psychoactive substance use, unspecified with psychoactive substance-induced psychotic disorder └F19.950Other psychoactive substance use, unspecified with psychoactive substance-induced psychotic disorder with delusions

└F19.950Other psychoactive substance use, unspecified with psychoactive substance-induced psychotic disorder with delusions