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ICD-10 Guide
ICD-10 CodesF16.280

F16.280

Billable

Hallucinogen dependence with hallucinogen-induced anxiety disorder

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

Code Description

ICD-10 F16.280 is a billable code used to indicate a diagnosis of hallucinogen dependence with hallucinogen-induced anxiety disorder.

Key Diagnostic Point:

Hallucinogen dependence with hallucinogen-induced anxiety disorder refers to a condition where an individual exhibits a compulsive pattern of hallucinogen use, leading to significant impairment or distress. This dependence is characterized by a strong desire to consume hallucinogens, tolerance to their effects, and withdrawal symptoms when not using. The anxiety disorder component indicates that the individual experiences anxiety symptoms directly attributable to hallucinogen use, which may include panic attacks, excessive worry, or fear that is disproportionate to the situation. These symptoms can persist even after the acute effects of the drug have worn off, complicating the clinical picture. Treatment often involves a combination of psychotherapy, such as cognitive-behavioral therapy, and pharmacotherapy to manage anxiety symptoms. The interplay between substance dependence and anxiety disorders necessitates a comprehensive treatment approach to address both issues effectively.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between hallucinogen dependence and other substance use disorders.
  • Identifying the presence of hallucinogen-induced anxiety disorder.
  • Documenting the severity and duration of symptoms.
  • Understanding the nuances of withdrawal symptoms versus intoxication effects.

Audit Risk Factors

  • Inadequate documentation of the patient's substance use history.
  • Failure to document the specific anxiety symptoms experienced.
  • Lack of evidence supporting the diagnosis of dependence.
  • Misclassification of the type of hallucinogen used.

Specialty Focus

Medical Specialties

Psychiatry

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with anxiety symptoms following hallucinogen use, or those with a history of substance use seeking treatment.

Billing Considerations

Consideration of the impact of hallucinogen use on existing mental health conditions.

Addiction Medicine

Documentation Requirements

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

Common Clinical Scenarios

Patients in withdrawal or seeking detoxification services for hallucinogen dependence.

Billing Considerations

Integration of behavioral therapies with pharmacological treatments for anxiety.

Coding Guidelines

Inclusion Criteria

Use F16.280 When
  • According to ICD
  • 10 guidelines, F16
  • 280 should be used when both hallucinogen dependence and hallucinogen
  • induced anxiety disorder are present
  • Documentation must clearly indicate the relationship between substance use and anxiety symptoms

Exclusion Criteria

Do NOT use F16.280 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99213CPT Code

Established patient office visit, Level 3

Clinical Scenario

Used for follow-up visits for patients with hallucinogen dependence and anxiety.

Documentation Requirements

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

Specialty Considerations

Psychiatrists may need to provide additional details on the patient's mental health status.

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 hallucinogen dependence and associated mental health conditions, improving the accuracy of treatment and reimbursement.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of substance use disorders, including the differentiation of hallucinogen dependence and associated mental health conditions, improving the accuracy of treatment and reimbursement.

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 is the difference between hallucinogen dependence and hallucinogen-induced anxiety disorder?

Hallucinogen dependence refers to the compulsive use of hallucinogens leading to tolerance and withdrawal, while hallucinogen-induced anxiety disorder is characterized by anxiety symptoms that arise directly from hallucinogen use. Both conditions can occur simultaneously, necessitating careful documentation and treatment.