ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesChapter 5: Mental, Behavioral and Neurodevelopmental disordersF55

F55

Billable

Abuse of non-psychoactive substances

Chapter 5:Mental, Behavioral and Neurodevelopmental disorders

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

Code Description

ICD-10 F55 is a billable code used to indicate a diagnosis of abuse of non-psychoactive substances.

Key Diagnostic Point:

F55 refers to the abuse of non-psychoactive substances, which are substances that do not primarily affect the central nervous system in a way that alters perception, mood, or consciousness. This code is often associated with behaviors that can lead to physical or psychological harm, particularly in the context of eating disorders, sleep disorders, sexual dysfunction, and behavioral syndromes. Individuals may misuse substances such as herbal supplements, over-the-counter medications, or other non-psychoactive agents to achieve specific effects, such as weight loss, sleep induction, or enhancement of sexual performance. The misuse of these substances can lead to significant health complications, including nutritional deficiencies, metabolic imbalances, and psychological distress. Accurate diagnosis and coding are essential for effective treatment and management of these conditions, as they often overlap with other mental health disorders and require a comprehensive approach to care.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of non-psychoactive substances that can be abused
  • Overlap with other mental health disorders
  • Need for thorough documentation to establish abuse versus legitimate use
  • Potential for co-occurring conditions that complicate diagnosis

Audit Risk Factors

  • Inadequate documentation of substance use history
  • Failure to differentiate between abuse and legitimate use
  • Misclassification of symptoms related to other mental health disorders
  • Lack of comprehensive treatment plans in documentation

Specialty Focus

Medical Specialties

Psychiatry

Documentation Requirements

Detailed patient history, including substance use patterns and associated behaviors.

Common Clinical Scenarios

Patients presenting with eating disorders who misuse supplements for weight loss.

Billing Considerations

Consideration of co-occurring mental health disorders and their impact on treatment.

Endocrinology

Documentation Requirements

Thorough evaluation of metabolic effects and hormonal imbalances due to substance misuse.

Common Clinical Scenarios

Patients with weight management issues using non-psychoactive substances to alter metabolism.

Billing Considerations

Monitoring for potential endocrine disruptions caused by substance abuse.

Coding Guidelines

Inclusion Criteria

Use F55 When
  • According to ICD
  • 10 guidelines, F55 should be used when there is clear evidence of abuse of non
  • psychoactive substances
  • Documentation must support the diagnosis, including the nature of the substance, the context of its use, and any associated health complications

Exclusion Criteria

Do NOT use F55 When
  • Exclusion criteria include legitimate medical use of the substance

Related CPT Codes

99213CPT Code

Established patient office visit, Level 3

Clinical Scenario

Used for follow-up visits for patients with substance abuse issues.

Documentation Requirements

Document the patient's substance use history and treatment progress.

Specialty Considerations

Psychiatric evaluations may require additional 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 substance abuse issues, including non-psychoactive substances. This specificity aids in better tracking and management of these conditions, improving patient care and outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of substance abuse issues, including non-psychoactive substances. This specificity aids in better tracking and management of these conditions, improving patient care and outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of substance abuse issues, including non-psychoactive substances. This specificity aids in better tracking and management of these conditions, improving patient care and outcomes.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What constitutes abuse of non-psychoactive substances?

Abuse of non-psychoactive substances involves using these substances in a manner that is harmful or detrimental to one's health, often for purposes such as weight loss, sleep enhancement, or performance improvement, without medical supervision.