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ICD-10 Guide
ICD-10 CodesF13.150

F13.150

Billable

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

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

Code Description

ICD-10 F13.150 is a billable code used to indicate a diagnosis of sedative, hypnotic or anxiolytic abuse with sedative, hypnotic or anxiolytic-induced psychotic disorder with delusions.

Key Diagnostic Point:

F13.150 refers to a condition characterized by the abuse of sedative, hypnotic, or anxiolytic substances, leading to a psychotic disorder that manifests with delusions. This condition typically arises when individuals misuse medications such as benzodiazepines or barbiturates, which are commonly prescribed for anxiety or sleep disorders. The abuse can result in significant alterations in mood, perception, and cognition, culminating in delusions—false beliefs that are firmly held despite contradictory evidence. Patients may exhibit paranoia, hallucinations, or other psychotic symptoms, complicating their clinical picture. Treatment often requires a multidisciplinary approach, including detoxification, psychiatric evaluation, and long-term rehabilitation strategies to address both the substance use disorder and the underlying mental health issues. Proper documentation and coding are crucial for effective treatment planning and reimbursement.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Differentiating between substance-induced psychotic disorders and primary psychotic disorders.
  • Identifying the specific substance and its impact on the patient's mental state.
  • Documenting the severity and duration of symptoms to justify the diagnosis.
  • Navigating the nuances of substance abuse versus dependence.

Audit Risk Factors

  • Inadequate documentation of the psychotic symptoms.
  • Failure to specify the substance abused.
  • Lack of evidence for the duration of symptoms.
  • Misclassification of the disorder as a primary psychotic disorder.

Specialty Focus

Medical Specialties

Psychiatry

Documentation Requirements

Comprehensive psychiatric evaluation, including history of substance use, mental status examination, and treatment plan.

Common Clinical Scenarios

Patients presenting with acute psychosis following sedative use, chronic users seeking help, or those with co-occurring disorders.

Billing Considerations

Careful assessment of the patient's substance use history and mental health status is essential for accurate diagnosis and treatment.

Addiction Medicine

Documentation Requirements

Detailed substance use history, assessment of withdrawal symptoms, and treatment response.

Common Clinical Scenarios

Patients undergoing detoxification, those in rehabilitation programs, or individuals with a history of multiple substance use disorders.

Billing Considerations

Integration of mental health treatment with addiction recovery strategies is crucial for successful outcomes.

Coding Guidelines

Inclusion Criteria

Use F13.150 When
  • According to ICD
  • 10 guidelines, F13
  • 150 should be used when there is clear evidence of sedative, hypnotic, or anxiolytic abuse leading to a psychotic disorder with delusions
  • Documentation must support the diagnosis, including the substance involved and the nature of the psychotic symptoms

Exclusion Criteria

Do NOT use F13.150 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 F13.150.

Documentation Requirements

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

Specialty Considerations

Psychiatrists should ensure comprehensive evaluations 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 substance abuse. 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 substance abuse. 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 substance abuse. 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 F13.150 and F13.149?

F13.150 includes the presence of delusions as part of the psychotic disorder, while F13.149 does not specify delusions, indicating a less severe presentation of psychotic symptoms.