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ICD-10 Guide
ICD-10 CodesF13.15

F13.15

Billable

Sedative, hypnotic or anxiolytic abuse with sedative, hypnotic or anxiolytic-induced psychotic disorder

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

Code Description

ICD-10 F13.15 is a billable code used to indicate a diagnosis of sedative, hypnotic or anxiolytic abuse with sedative, hypnotic or anxiolytic-induced psychotic disorder.

Key Diagnostic Point:

F13.15 refers to a condition characterized by the abuse of sedative, hypnotic, or anxiolytic substances, leading to the development of a psychotic disorder induced by these substances. Patients may exhibit symptoms such as hallucinations, delusions, and severe mood disturbances, which are directly attributable to the use of these drugs. This code is applicable when the substance use has resulted in significant impairment in social, occupational, or other important areas of functioning. The diagnosis requires a thorough assessment of the patient's substance use history, mental status examination, and the exclusion of other potential causes of psychosis. Treatment often involves a combination of detoxification, psychiatric intervention, and long-term rehabilitation strategies to address both the substance use disorder and the associated psychotic symptoms.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Differentiating between substance-induced psychotic disorder and primary psychotic disorders.
  • Need for comprehensive documentation of substance use history and current mental status.
  • Potential for co-occurring mental health disorders complicating the diagnosis.
  • Variability in symptoms and severity among patients, requiring careful assessment.

Audit Risk Factors

  • Inadequate documentation of substance use history.
  • Failure to document the severity and duration of psychotic symptoms.
  • Misclassification of the primary diagnosis leading to incorrect coding.
  • Lack of evidence for the relationship between substance use and psychotic symptoms.

Specialty Focus

Medical Specialties

Psychiatry

Documentation Requirements

Detailed mental status examination, substance use history, and treatment plan.

Common Clinical Scenarios

Patients presenting with acute psychosis following sedative use, or those in withdrawal experiencing psychotic symptoms.

Billing Considerations

Consideration of comorbid psychiatric disorders and the need for a multidisciplinary approach to treatment.

Addiction Medicine

Documentation Requirements

Comprehensive assessment of substance use patterns, withdrawal symptoms, and treatment history.

Common Clinical Scenarios

Patients undergoing detoxification who exhibit psychotic symptoms related to sedative use.

Billing Considerations

Focus on harm reduction strategies and long-term recovery planning.

Coding Guidelines

Inclusion Criteria

Use F13.15 When
  • According to ICD
  • 10 coding guidelines, F13
  • 15 should be used when there is clear evidence of substance abuse leading to psychotic symptoms
  • Documentation must support the diagnosis, including the timeline of substance use and onset of psychotic symptoms

Exclusion Criteria

Do NOT use F13.15 When
  • Exclusion criteria include primary psychotic disorders not related to substance use

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 F13.15.

Documentation Requirements

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

Specialty Considerations

Psychiatrists should ensure comprehensive assessments are documented to support the complexity of care.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of substance use disorders, including the differentiation of psychotic disorders induced by sedatives. This specificity aids in better treatment planning and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of substance use disorders, including the differentiation of psychotic disorders induced by sedatives. This specificity aids in better treatment planning and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of substance use disorders, including the differentiation of psychotic disorders induced by sedatives. This specificity aids in better treatment planning and resource allocation.

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 F13.15 and F13.10?

F13.15 includes the presence of psychotic symptoms induced by sedative, hypnotic, or anxiolytic abuse, while F13.10 refers to abuse without such symptoms.