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ICD-10 Guide
ICD-10 CodesF12.15

F12.15

Billable

Cannabis abuse with psychotic disorder

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 F12.15 is a billable code used to indicate a diagnosis of cannabis abuse with psychotic disorder.

Key Diagnostic Point:

Cannabis abuse with psychotic disorder refers to a condition where an individual exhibits a pattern of cannabis use that leads to significant impairment or distress, accompanied by symptoms of psychosis. This may include hallucinations, delusions, or disorganized thinking that arise during or shortly after cannabis use. The diagnosis is made when the psychotic symptoms are severe enough to warrant clinical attention and are not better explained by other mental health disorders or substance use. The condition can lead to various complications, including social and occupational dysfunction, and may require comprehensive treatment strategies that include psychotherapy, medication management, and support groups. Treatment often focuses on both the substance use disorder and the underlying psychotic symptoms, necessitating a multidisciplinary approach to care. The prognosis can vary widely based on the severity of the abuse, the presence of co-occurring disorders, and the individual's support system.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between cannabis-induced psychosis and primary psychotic disorders.
  • Identifying the severity of cannabis abuse and its impact on mental health.
  • Documenting the duration and frequency of cannabis use.
  • Understanding the interplay between cannabis use and other mental health conditions.

Audit Risk Factors

  • Inadequate documentation of psychotic symptoms.
  • Failure to differentiate between substance-induced and primary psychotic disorders.
  • Insufficient evidence of treatment plans addressing both cannabis abuse and psychosis.
  • Lack of follow-up documentation to support ongoing treatment.

Specialty Focus

Medical Specialties

Psychiatry

Documentation Requirements

Detailed psychiatric evaluations, including history of substance use and mental health symptoms.

Common Clinical Scenarios

Patients presenting with acute psychosis following cannabis use, or chronic cannabis users developing psychotic symptoms.

Billing Considerations

Careful documentation of the timeline of cannabis use in relation to the onset of psychotic symptoms.

Addiction Medicine

Documentation Requirements

Comprehensive substance use history and assessment of withdrawal symptoms.

Common Clinical Scenarios

Patients in detoxification programs exhibiting psychotic symptoms related to cannabis use.

Billing Considerations

Integration of treatment plans that address both addiction and mental health needs.

Coding Guidelines

Inclusion Criteria

Use F12.15 When
  • According to ICD
  • 10 guidelines, F12
  • 15 should be used when cannabis abuse is accompanied by psychotic symptoms
  • Coders must ensure that the psychotic symptoms are not better accounted for by other mental health disorders
  • Documentation should clearly outline the relationship between cannabis use and the psychotic disorder

Exclusion Criteria

Do NOT use F12.15 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99214CPT Code

Established patient office visit, moderate complexity

Clinical Scenario

Used for follow-up visits for patients diagnosed with cannabis abuse and psychotic disorder.

Documentation Requirements

Document the patient's mental status, substance use history, and treatment response.

Specialty Considerations

Psychiatrists should ensure comprehensive mental health assessments are included.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of cannabis-related disorders, improving the ability to track and treat conditions like cannabis abuse with psychotic disorder. This specificity aids in better understanding the prevalence and treatment outcomes of these disorders.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of cannabis-related disorders, improving the ability to track and treat conditions like cannabis abuse with psychotic disorder. This specificity aids in better understanding the prevalence and treatment outcomes of these disorders.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of cannabis-related disorders, improving the ability to track and treat conditions like cannabis abuse with psychotic disorder. This specificity aids in better understanding the prevalence and treatment outcomes of these disorders.

Resources

Clinical References

  • •
    Substance Abuse and Mental Health Services Administration (SAMHSA)

Coding & Billing References

  • •
    Substance Abuse and Mental Health Services Administration (SAMHSA)

Frequently Asked Questions

What is the difference between cannabis abuse and cannabis dependence?

Cannabis abuse refers to the harmful use of cannabis that leads to significant impairment or distress, while cannabis dependence involves a more severe pattern of use characterized by tolerance, withdrawal symptoms, and compulsive use despite negative consequences.