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ICD-10 Guide
ICD-10 CodesF12.951

F12.951

Billable

Cannabis use, unspecified with psychotic disorder with hallucinations

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

Code Description

ICD-10 F12.951 is a billable code used to indicate a diagnosis of cannabis use, unspecified with psychotic disorder with hallucinations.

Key Diagnostic Point:

F12.951 refers to a condition characterized by the use of cannabis leading to a psychotic disorder that includes hallucinations. This diagnosis is often seen in individuals who consume cannabis in varying amounts and frequencies, leading to significant alterations in perception, thought processes, and behavior. The psychotic symptoms may manifest as delusions, hallucinations, or disorganized thinking, which can severely impact the individual's daily functioning and quality of life. The diagnosis is made when the symptoms are not better explained by other mental health disorders or substance use disorders. Treatment typically involves a combination of psychotherapy, medication management, and support for substance use cessation. Clinicians must carefully assess the patient's history of cannabis use, the severity of psychotic symptoms, and any co-occurring mental health conditions to develop an effective treatment plan.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between primary psychotic disorders and substance-induced psychosis.
  • Assessing the severity and duration of cannabis use.
  • Documenting the presence of hallucinations and their impact on functioning.
  • Identifying co-occurring mental health disorders.

Audit Risk Factors

  • Inadequate documentation of psychotic symptoms.
  • Failure to differentiate between substance-induced and primary psychotic disorders.
  • Lack of evidence for the severity of cannabis use.
  • Insufficient follow-up documentation on treatment outcomes.

Specialty Focus

Medical Specialties

Psychiatry

Documentation Requirements

Detailed mental status examination, history of substance use, and assessment of psychotic symptoms.

Common Clinical Scenarios

Patients presenting with acute psychosis after cannabis use, chronic cannabis users developing psychotic symptoms.

Billing Considerations

Consideration of the patient's overall mental health history and any previous episodes of psychosis.

Addiction Medicine

Documentation Requirements

Comprehensive substance use history, assessment of withdrawal symptoms, and treatment plan for cessation.

Common Clinical Scenarios

Patients seeking help for cannabis dependence with concurrent psychotic symptoms.

Billing Considerations

Integration of substance use treatment with mental health care.

Coding Guidelines

Inclusion Criteria

Use F12.951 When
  • According to ICD
  • 10 guidelines, F12
  • 951 should be used when cannabis use is associated with a psychotic disorder characterized by hallucinations
  • It is essential to document the duration and severity of symptoms and any relevant co
  • occurring conditions

Exclusion Criteria

Do NOT use F12.951 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

90834CPT Code

Psychotherapy, 45 minutes with patient

Clinical Scenario

Used for ongoing therapy for patients with cannabis-induced psychosis.

Documentation Requirements

Document the patient's mental status and progress in therapy.

Specialty Considerations

Psychiatrists should focus on the interplay between substance use and mental health.

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 these conditions 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 these conditions 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 these conditions 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 F12.951 and F12.950?

F12.951 includes the presence of psychotic disorder with hallucinations, while F12.950 is for cannabis use without any specified mental health complications.