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ICD-10 Guide
ICD-10 CodesF12.950

F12.950

Billable

Cannabis use, unspecified with psychotic disorder with delusions

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

Code Description

ICD-10 F12.950 is a billable code used to indicate a diagnosis of cannabis use, unspecified with psychotic disorder with delusions.

Key Diagnostic Point:

F12.950 refers to a condition characterized by the use of cannabis leading to a psychotic disorder, specifically with delusions. This diagnosis is often seen in individuals who consume cannabis in varying amounts and frequencies, leading to significant alterations in perception, thought processes, and behavior. The psychotic symptoms can manifest as delusions, which are false beliefs that are firmly held despite contradictory evidence. These delusions can significantly impair social and occupational functioning. The onset of symptoms may occur during or shortly after cannabis use, and the severity can vary based on individual susceptibility, the potency of the cannabis used, and the presence of other mental health disorders. Treatment typically involves a combination of psychiatric intervention, including antipsychotic medications, and substance use disorder therapies, such as cognitive-behavioral therapy (CBT) and motivational interviewing. Understanding the interplay between cannabis use and psychotic disorders is crucial for effective management and recovery.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between primary psychotic disorders and substance-induced psychosis.
  • Need for comprehensive documentation of substance use history.
  • Assessment of co-occurring mental health disorders.
  • Variability in symptom presentation based on individual factors.

Audit Risk Factors

  • Inadequate documentation of cannabis use history.
  • Failure to document the presence and nature of delusions.
  • Lack of evidence for the impact of symptoms on functioning.
  • Misalignment between diagnosis and treatment provided.

Specialty Focus

Medical Specialties

Psychiatry

Documentation Requirements

Detailed mental status examination, history of substance use, and assessment of delusions.

Common Clinical Scenarios

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

Billing Considerations

Consideration of differential diagnoses and the need for a comprehensive treatment plan.

Addiction Medicine

Documentation Requirements

Substance use history, treatment history, and psychosocial assessment.

Common Clinical Scenarios

Patients in withdrawal from cannabis with psychotic symptoms, those in recovery experiencing relapse.

Billing Considerations

Integration of substance use treatment with mental health care.

Coding Guidelines

Inclusion Criteria

Use F12.950 When
  • Follow the ICD
  • CM coding guidelines for substance use disorders, ensuring accurate documentation of the relationship between cannabis use and psychotic symptoms
  • Include any relevant co
  • occurring diagnoses

Exclusion Criteria

Do NOT use F12.950 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99214CPT Code

Established patient office visit, level 4

Clinical Scenario

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

Documentation Requirements

Document history of present illness, review of systems, and mental status examination.

Specialty Considerations

Psychiatrists should ensure thorough documentation of mental health assessments.

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.

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.

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.

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 F12.950 and F12.930?

F12.950 includes the presence of delusions as part of the psychotic disorder, while F12.930 does not specify the presence of delusions, indicating a broader category of cannabis-related psychosis.