R78.3 ICD-10-CM Code: Finding of hallucinogen in blood
HCC Buddy Code Card
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FY 2026 Apr update / Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99) / Abnormal findings on examination of blood, without diagnosis (R70-R79)
R78.3
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceFinding of hallucinogen in blood
Detection of hallucinogenic drugs (such as LSD, psilocybin, or PCP) in the bloodstream.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for R78.3 in this effective period.
Excludes 2
Official- mental or behavioral disorders due to psychoactive substance use (F10-F19)
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for R78.3 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for R78.3 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for R78.3 in this effective period.
Use Additional
Official- code to identify the any retained foreign body, if applicable (Z18.-)
Code Also
OfficialICD-10-CM does not list Code Also instructions for R78.3 in this effective period.
Buddy Documentation Tip
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is R78.3 an HCC code?
No. R78.3 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
- Code
- R78.3
- Description
- Finding of hallucinogen in blood
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
R78.3 is the ICD-10-CM diagnosis code for finding of hallucinogen in blood. Detection of hallucinogenic drugs (such as LSD, psilocybin, or PCP) in the bloodstream. R78.3 sits in the ICD-10-CM chapter for symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (r00-r99), within the section covering abnormal findings on examination of blood, without diagnosis (r70-r79).
R78.3 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
Document the specific hallucinogen identified when possible for clarity.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for R78.3 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document the specific hallucinogen identified when possible for clarity
- •If acute intoxication or adverse effects are documented, code those conditions separately