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ICD-10 Guide
ICD-10 CodesF13.151

F13.151

Billable

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

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

Code Description

ICD-10 F13.151 is a billable code used to indicate a diagnosis of sedative, hypnotic or anxiolytic abuse with sedative, hypnotic or anxiolytic-induced psychotic disorder with hallucinations.

Key Diagnostic Point:

F13.151 refers to a condition characterized by the abuse of sedative, hypnotic, or anxiolytic substances, leading to a psychotic disorder that includes hallucinations. Patients with this diagnosis typically exhibit a pattern of excessive use of medications such as benzodiazepines or barbiturates, which can result in significant impairment in social, occupational, or other important areas of functioning. The psychotic disorder manifests as hallucinations, which can be auditory, visual, or tactile, and may occur during intoxication or withdrawal from these substances. The diagnosis requires careful assessment to differentiate between substance-induced symptoms and primary psychotic disorders. Treatment often involves a combination of detoxification, psychiatric intervention, and long-term rehabilitation strategies to address both the substance use disorder and the psychotic symptoms.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Differentiating between substance-induced and primary psychotic disorders
  • Need for comprehensive documentation of substance use history
  • Potential for co-occurring mental health disorders
  • Variability in symptoms based on substance type and duration of use

Audit Risk Factors

  • Inadequate documentation of substance use history
  • Failure to document the presence and type of hallucinations
  • Misclassification of the primary diagnosis
  • Lack of evidence for treatment plans addressing both substance use and psychosis

Specialty Focus

Medical Specialties

Psychiatry

Documentation Requirements

Detailed psychiatric evaluations, including mental status exams and substance use history.

Common Clinical Scenarios

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

Billing Considerations

Documentation must clearly differentiate between substance-induced symptoms and underlying psychiatric disorders.

Addiction Medicine

Documentation Requirements

Comprehensive substance use assessments and treatment plans.

Common Clinical Scenarios

Patients undergoing detoxification from sedatives with concurrent psychotic symptoms.

Billing Considerations

Focus on the integration of mental health and addiction treatment strategies.

Coding Guidelines

Inclusion Criteria

Use F13.151 When
  • According to ICD
  • 10 guidelines, F13
  • 151 should be used when there is clear evidence of sedative, hypnotic, or anxiolytic abuse leading to a psychotic disorder with hallucinations
  • Documentation must support the diagnosis, including the timeline of substance use and the onset of psychotic symptoms

Exclusion Criteria

Do NOT use F13.151 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 F13.151.

Documentation Requirements

Document the patient's substance use history, current symptoms, and treatment plan.

Specialty Considerations

Psychiatric evaluations should include mental status exams and risk assessments.

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 F13.151 and F13.10?

F13.151 includes the presence of a psychotic disorder with hallucinations due to sedative, hypnotic, or anxiolytic abuse, while F13.10 does not involve psychotic symptoms.