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ICD-10 Guide
ICD-10 CodesF16.122

F16.122

Billable

Hallucinogen abuse with intoxication with perceptual disturbance

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

Code Description

ICD-10 F16.122 is a billable code used to indicate a diagnosis of hallucinogen abuse with intoxication with perceptual disturbance.

Key Diagnostic Point:

F16.122 refers to a condition characterized by the abuse of hallucinogenic substances, leading to intoxication that manifests as perceptual disturbances. Hallucinogens, such as LSD, psilocybin, and mescaline, can alter an individual's perception of reality, causing visual and auditory hallucinations, altered sense of time, and profound changes in thought processes. The intoxication phase can lead to significant impairment in social and occupational functioning, as well as potential harm to oneself or others. Symptoms may include anxiety, paranoia, and confusion, which can escalate to more severe psychological disturbances. Treatment often involves supportive care, counseling, and in some cases, medication to manage acute symptoms. Long-term management may require participation in substance use disorder treatment programs, including cognitive-behavioral therapy and support groups, to address underlying issues related to addiction and to prevent relapse.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation of symptoms among individuals
  • Need for comprehensive documentation of substance use history
  • Differentiation from other substance use disorders
  • Potential for co-occurring mental health conditions

Audit Risk Factors

  • Inadequate documentation of substance use history
  • Failure to document specific perceptual disturbances
  • Misclassification of intoxication severity
  • Lack of evidence for treatment interventions

Specialty Focus

Medical Specialties

Psychiatry

Documentation Requirements

Detailed patient history, including substance use patterns and mental health evaluations.

Common Clinical Scenarios

Patients presenting with acute psychosis or severe anxiety following hallucinogen use.

Billing Considerations

Documentation must clearly outline the relationship between hallucinogen use and psychiatric symptoms.

Addiction Medicine

Documentation Requirements

Comprehensive assessment of substance use, including frequency, duration, and impact on functioning.

Common Clinical Scenarios

Patients seeking treatment for hallucinogen dependence or those experiencing withdrawal symptoms.

Billing Considerations

Focus on treatment plans that address both addiction and any co-occurring mental health disorders.

Coding Guidelines

Inclusion Criteria

Use F16.122 When
  • According to ICD
  • 10 coding guidelines, F16
  • 122 should be used when there is clear documentation of hallucinogen abuse leading to intoxication with perceptual disturbances
  • It is essential to document the specific hallucinogen used and the nature of the perceptual disturbances

Exclusion Criteria

Do NOT use F16.122 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99214CPT Code

Established patient office visit, level 4

Clinical Scenario

Used when a patient with hallucinogen abuse presents for follow-up care.

Documentation Requirements

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

Specialty Considerations

Psychiatry may require additional 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 hallucinogen-related disorders, improving the ability to track and manage these conditions in clinical practice.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of hallucinogen-related disorders, improving the ability to track and manage these conditions in clinical practice.

Reimbursement & Billing Impact

reimbursement.

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 are the key symptoms of hallucinogen intoxication?

Key symptoms include visual and auditory hallucinations, altered perception of time and space, anxiety, paranoia, and changes in thought processes.