F19.99
BillableOther psychoactive substance use, unspecified with unspecified psychoactive substance-induced disorder
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 mental or behavioral disorder caused by psychoactive substance use where the specific type of disorder is not clearly documented or specified.
Coding Tips
- •This is a last-resort code; attempt to identify the specific substance-induced disorder when possible
- •Request clarification from the provider about the nature of the substance-induced condition
Clinical Significance
Other psychoactive substance use, unspecified with unspecified substance-induced disorder is the least specific code in the F19.9X range, indicating both the substance use pattern and the induced disorder type are unspecified. While it still captures an HCC, it represents a significant documentation gap. This code should prompt aggressive provider querying to identify the specific substances used, the pattern of use (abuse vs. dependence), and the nature of the induced disorder.
Documentation Requirements
- ✓Documentation of psychoactive substance use with some induced disorder present
- ✓Attempt to identify the specific substance(s) through provider query
- ✓Attempt to specify the use pattern (use, abuse, or dependence) through provider query
- ✓Attempt to identify the specific induced disorder through provider query
- ✓Any available clinical details about the substance-related condition
- ✓Treatment plan documentation
Commonly Confused Codes
F19.988 — OTHER specified substance-induced disorder when the disorder IS known but lacks a specific codeF19.9 — Substance use, unspecified (no induced disorder) is different from F19.99 which includes an induced disorderF19.20 — Substance DEPENDENCE, uncomplicated should be used when dependence criteria and no induced disorder are documentedF19.29 — Substance DEPENDENCE with unspecified induced disorder; at least the dependence pattern is specified
Code Hierarchy
└F19Other psychoactive substance related disorders└F19.9Other psychoactive substance use, unspecified└F19.99Other psychoactive substance use, unspecified with unspecified psychoactive substance-induced disorder
└F19.99Other psychoactive substance use, unspecified with unspecified psychoactive substance-induced disorder