ICD-10-CM Billable Code

F16.959

Hallucinogen use, unspecified with hallucinogen-induced psychotic disorder, unspecified

Clinical Classification Guidelines

Inclusion Terms

  • Other hallucinogen induced psychotic disorder, without use disorder
  • Phencyclidine induced psychotic disorder, without use disorder

Medical Intelligence & Overview

Hallucinogen-induced psychotic disorder is a mental health condition characterized by psychotic symptoms triggered by the use of hallucinogenic substances. The ICD-10 code F16.959 specifically pertains to cases where the type of hallucinogen is unspecified, and the psychotic disorder is also unspecified. This condition can occur in individuals who have used hallucinogens without necessarily developing a chronic use disorder, and it is important to understand its causes, symptoms, diagnosis, and possible management approaches.

Causes & Symptoms

Clinical Causes: Use of hallucinogenic substances such as LSD, psilocybin, or mescaline, even without a confirmed substance use disorder Phencyclidine (PCP) or other dissociative drugs' use leading to psychotic symptoms Underlying mental health vulnerabilities that may be triggered by hallucinogen use

Key Symptoms: Auditory or visual hallucinations that are clearly perceptible to others Disorganized thinking and speech influencing the ability to communicate effectively Suspiciousness or paranoid delusions Emotional disturbances such as anxiety, fear, or agitation Altered perception of reality, often leading to confusion and impaired judgment Physical symptoms like dilated pupils, increased heart rate, or tremors during the episode Potential agitation or aggressive behavior depending on severity

Diagnostic & Treatment

Diagnosis Path: Diagnosis is typically based on a detailed clinical history and mental health evaluation, focusing on recent hallucinogen use and associated psychotic symptoms. No specific laboratory tests can confirm the disorder, but toxicology screenings may be used to detect recent drug use. Healthcare providers assess the timing, context, and presence of psychotic features to differentiate this disorder from other psychiatric or medical conditions.

Treatment Protocols: Management often involves a combination of approaches aimed at alleviating symptoms and preventing further episodes. This may include pharmacological interventions such as antipsychotics for acute psychosis, as well as supportive therapies that provide a safe environment. Addressing underlying substance use and offering psychoeducation or counseling are critical components of long-term care. In cases where the psychotic symptoms resolve after cessation of the hallucinogen, ongoing mental health support may still be necessary to monitor for recurrence or underlying psychiatric conditions.

Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.

Clinical Advice & FAQs

Billing Guidance

Is F16.959 a billable ICD-10 code?
Yes, F16.959 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.

Documentation

How do I report F16.959?
Clinical documentation must specify the nature of Hallucinogen use, unspecified with hallucinogen-induced psychotic disorder, unspecified and any associated comorbidities for accurate reporting.

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