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ICD-10 Guide
ICD-10 CodesF12.159

F12.159

Billable

Cannabis abuse with psychotic disorder, unspecified

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

Code Description

ICD-10 F12.159 is a billable code used to indicate a diagnosis of cannabis abuse with psychotic disorder, unspecified.

Key Diagnostic Point:

Cannabis abuse with psychotic disorder, unspecified, 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 are directly attributable to cannabis use. The diagnosis is made when the psychotic symptoms cannot be better explained by another mental disorder or substance use. The severity of the disorder can vary, and it may manifest in different ways depending on the individual's history, the amount and frequency of cannabis use, and any co-occurring mental health conditions. Treatment typically involves a combination of psychotherapy, psychoeducation, and, in some cases, pharmacotherapy to manage psychotic symptoms. It is crucial for healthcare providers to assess the patient's substance use history and mental health status comprehensively to develop an effective treatment plan.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between cannabis-induced psychosis and primary psychotic disorders.
  • Need for comprehensive documentation of substance use history.
  • Potential for co-occurring mental health disorders complicating diagnosis.
  • Variability in symptom presentation among individuals.

Audit Risk Factors

  • Inadequate documentation of psychotic symptoms.
  • Failure to differentiate between substance-induced and primary psychotic disorders.
  • Lack of comprehensive substance use history.
  • Misclassification of the severity of the disorder.

Specialty Focus

Medical Specialties

Psychiatry

Documentation Requirements

Detailed mental health assessments, including history of substance use and current symptoms.

Common Clinical Scenarios

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

Billing Considerations

Consideration of other mental health disorders and the potential need for multidisciplinary treatment approaches.

Addiction Medicine

Documentation Requirements

Thorough documentation of substance use patterns, withdrawal symptoms, and treatment response.

Common Clinical Scenarios

Patients in recovery programs experiencing relapse or exacerbation of psychotic symptoms.

Billing Considerations

Integration of addiction treatment with psychiatric care for optimal outcomes.

Coding Guidelines

Inclusion Criteria

Use F12.159 When
  • Follow the ICD
  • CM coding guidelines for substance use disorders, ensuring accurate documentation of the relationship between cannabis use and psychotic symptoms

Exclusion Criteria

Do NOT use F12.159 When
  • Exclude codes for primary psychotic disorders unless cannabis use is clearly implicated

Related ICD-10 Codes

Related CPT Codes

90791CPT Code

Psychiatric diagnostic evaluation

Clinical Scenario

Used when assessing a patient with cannabis abuse and psychotic symptoms.

Documentation Requirements

Comprehensive mental health history and current symptom assessment.

Specialty Considerations

Psychiatrists should ensure thorough documentation of substance use history.

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 these conditions effectively. The granularity of ICD-10 codes helps in understanding the prevalence and impact of cannabis use on mental health.

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 these conditions effectively. The granularity of ICD-10 codes helps in understanding the prevalence and impact of cannabis use on mental health.

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 these conditions effectively. The granularity of ICD-10 codes helps in understanding the prevalence and impact of cannabis use on mental health.

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 are the key symptoms of cannabis abuse with psychotic disorder?

Key symptoms include hallucinations, delusions, disorganized thinking, and significant impairment in social or occupational functioning, all directly related to cannabis use.