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ICD-10 Guide
ICD-10 CodesF12.959

F12.959

Billable

Cannabis use, unspecified with psychotic disorder, unspecified

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

Code Description

ICD-10 F12.959 is a billable code used to indicate a diagnosis of cannabis use, unspecified with psychotic disorder, unspecified.

Key Diagnostic Point:

F12.959 refers to a diagnosis of cannabis use disorder accompanied by a psychotic disorder, where the specifics of both the substance use and the psychotic disorder are not clearly defined. Cannabis use disorder is characterized by a problematic pattern of cannabis use leading to clinically significant impairment or distress. Symptoms may include cravings, tolerance, withdrawal, and continued use despite negative consequences. The psychotic disorder may manifest as hallucinations, delusions, or disorganized thinking, which can be exacerbated by cannabis use. The interplay between cannabis and psychosis is complex, as cannabis can trigger or worsen psychotic symptoms in predisposed individuals. Treatment typically involves a combination of psychotherapy, psychoeducation, and, in some cases, pharmacotherapy to manage psychotic symptoms. Clinicians must carefully assess the patient's history and current mental state to provide appropriate care and support for recovery from both cannabis use and psychotic symptoms.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Unspecified nature of both cannabis use and psychotic disorder complicates diagnosis.
  • Variability in symptoms and severity of psychotic disorders associated with cannabis use.
  • Need for comprehensive documentation to support the diagnosis.
  • Potential overlap with other substance use disorders and mental health conditions.

Audit Risk Factors

  • Lack of detailed documentation regarding the patient's cannabis use history.
  • Insufficient evidence of psychotic symptoms related to cannabis use.
  • Inconsistent coding practices among providers.
  • Failure to document treatment plans and patient responses.

Specialty Focus

Medical Specialties

Psychiatry

Documentation Requirements

Detailed patient history, including substance use history and mental health evaluations.

Common Clinical Scenarios

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

Billing Considerations

Consideration of co-occurring mental health disorders and the impact of cannabis on treatment outcomes.

Addiction Medicine

Documentation Requirements

Comprehensive assessment of substance use patterns, including frequency and quantity of cannabis use.

Common Clinical Scenarios

Patients in withdrawal from cannabis or those seeking treatment for cannabis use disorder with psychotic features.

Billing Considerations

Integration of addiction treatment with psychiatric care for optimal patient outcomes.

Coding Guidelines

Inclusion Criteria

Use F12.959 When
  • According to ICD
  • 10 coding guidelines, F12
  • 959 should be used when there is cannabis use disorder with an unspecified psychotic disorder
  • Coders must ensure that documentation supports the diagnosis and that no more specific codes apply

Exclusion Criteria

Do NOT use F12.959 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

90791CPT Code

Psychiatric diagnostic evaluation

Clinical Scenario

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

Documentation Requirements

Comprehensive evaluation notes, including history and mental status examination.

Specialty Considerations

Psychiatrists should ensure thorough documentation to support the diagnosis.

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 manage these conditions. F12.959 provides a framework for understanding the complexities of cannabis use and its impact 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 manage these conditions. F12.959 provides a framework for understanding the complexities of cannabis use and its impact 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 manage these conditions. F12.959 provides a framework for understanding the complexities of cannabis use and its impact 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 use disorder?

Key symptoms include cravings, tolerance, withdrawal symptoms, and continued use despite negative consequences.

How does cannabis use relate to psychotic disorders?

Cannabis use can trigger or exacerbate psychotic symptoms, particularly in individuals with a predisposition to mental illness.

What treatment options are available for patients with F12.959?

Treatment typically includes psychotherapy, psychoeducation, and possibly medication to manage psychotic symptoms.