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v1.0.0
ICD-10 Guide
ICD-10 CodesF12.1

F12.1

Billable

Cannabis abuse

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

Code Description

ICD-10 F12.1 is a billable code used to indicate a diagnosis of cannabis abuse.

Key Diagnostic Point:

Cannabis abuse is characterized by a pattern of cannabis use leading to clinically significant impairment or distress. This includes recurrent use resulting in a failure to fulfill major role obligations at work, school, or home, and continued use despite persistent social or interpersonal problems caused or exacerbated by the effects of cannabis. Individuals may experience cravings, increased tolerance, and withdrawal symptoms when not using cannabis. The DSM-5 outlines specific criteria for diagnosing cannabis use disorder, which includes a range of behavioral, psychological, and physiological symptoms. Treatment often involves behavioral therapies, counseling, and support groups, with a focus on reducing use and addressing underlying issues. The prevalence of cannabis abuse has increased with changing legal statuses and societal attitudes towards cannabis, necessitating a comprehensive understanding of its impact on health and well-being.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in patient presentation and severity of abuse
  • Need for comprehensive documentation of substance use history
  • Differentiation from other substance use disorders
  • Potential for co-occurring mental health disorders

Audit Risk Factors

  • Inadequate documentation of substance use history
  • Failure to document the impact of cannabis use on daily functioning
  • Misclassification of cannabis abuse as dependence
  • Lack of evidence for treatment interventions

Specialty Focus

Medical Specialties

Addiction Medicine

Documentation Requirements

Detailed history of substance use, treatment history, and psychosocial factors.

Common Clinical Scenarios

Patients presenting with withdrawal symptoms, cravings, or co-occurring mental health disorders.

Billing Considerations

Consideration of legal status of cannabis in the patient's location and its impact on treatment options.

Psychiatry

Documentation Requirements

Comprehensive mental health evaluation, including assessment of cannabis use and its effects on mental health.

Common Clinical Scenarios

Patients with anxiety, depression, or psychosis related to cannabis use.

Billing Considerations

Differentiating between primary psychiatric disorders and those exacerbated by cannabis use.

Coding Guidelines

Inclusion Criteria

Use F12.1 When
  • According to ICD
  • 10 guidelines, F12
  • 1 should be used when cannabis use leads to significant impairment or distress
  • It is important to document the specific criteria met for diagnosis, including the frequency and context of use

Exclusion Criteria

Do NOT use F12.1 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99406CPT Code

Smoking and tobacco use cessation counseling visit

Clinical Scenario

Used when counseling patients about cannabis cessation.

Documentation Requirements

Document the counseling session details and patient responses.

Specialty Considerations

Addiction specialists may need to provide more extensive documentation.

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 treat cannabis abuse effectively.

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 treat cannabis abuse effectively.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of cannabis-related disorders, improving the ability to track and treat cannabis abuse effectively.

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 cannabis abuse and cannabis dependence?

Cannabis abuse refers to the use of cannabis that leads to significant impairment or distress without the presence of physical dependence, while cannabis dependence includes criteria such as tolerance and withdrawal symptoms.