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ICD-10 Guide
ICD-10 CodesF19.120

F19.120

Billable

Other psychoactive substance abuse with intoxication, uncomplicated

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

Code Description

ICD-10 F19.120 is a billable code used to indicate a diagnosis of other psychoactive substance abuse with intoxication, uncomplicated.

Key Diagnostic Point:

F19.120 refers to the abuse of psychoactive substances that do not fall under the more commonly recognized categories such as alcohol, opioids, or stimulants, and presents with uncomplicated intoxication. This condition is characterized by the consumption of substances that alter mood, perception, or cognitive function, leading to significant impairment or distress. Patients may exhibit symptoms such as altered mental status, euphoria, or dysphoria, and may require medical intervention to manage acute intoxication. The uncomplicated nature of the intoxication indicates that there are no severe complications such as withdrawal symptoms or co-occurring medical conditions. Treatment typically involves supportive care, monitoring vital signs, and addressing any immediate health concerns. Long-term management may include substance use disorder treatment programs, counseling, and support groups to prevent relapse and promote recovery.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of substances that can be classified under 'other psychoactive substances'
  • Need for precise documentation of the substance used
  • Differentiation from other substance use disorders
  • Potential for co-occurring mental health disorders

Audit Risk Factors

  • Inadequate documentation of the specific substance used
  • Failure to document the uncomplicated nature of intoxication
  • Misclassification of the substance leading to incorrect coding
  • Lack of evidence for the diagnosis of substance abuse

Specialty Focus

Medical Specialties

Addiction Medicine

Documentation Requirements

Detailed history of substance use, including types and amounts of substances used, and any previous treatment attempts.

Common Clinical Scenarios

Patients presenting with acute intoxication, requiring stabilization and assessment for further treatment.

Billing Considerations

Documentation must clearly indicate the absence of withdrawal symptoms or complications.

Psychiatry

Documentation Requirements

Comprehensive mental health evaluation, including assessment of co-occurring disorders.

Common Clinical Scenarios

Patients with a history of substance use presenting with mood or anxiety disorders.

Billing Considerations

Consideration of the patient's mental health history is crucial for accurate coding.

Coding Guidelines

Inclusion Criteria

Use F19.120 When
  • According to ICD
  • 10 guidelines, F19
  • 120 should be used when there is evidence of psychoactive substance abuse with uncomplicated intoxication
  • Documentation must support the diagnosis and specify the substance involved

Exclusion Criteria

Do NOT use F19.120 When
  • Exclusion criteria include severe withdrawal symptoms or complications

Related ICD-10 Codes

Related CPT Codes

H0001CPT Code

Alcohol and/or drug assessment

Clinical Scenario

Used when assessing a patient for substance use disorder.

Documentation Requirements

Document the assessment findings and recommendations.

Specialty Considerations

Addiction specialists should ensure comprehensive evaluations are performed.

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 F19.120, which helps in better tracking and management of these conditions. It emphasizes the importance of accurate documentation and coding practices.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of substance use disorders, including F19.120, which helps in better tracking and management of these conditions. It emphasizes the importance of accurate documentation and coding practices.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of substance use disorders, including F19.120, which helps in better tracking and management of these conditions. It emphasizes the importance of accurate documentation and coding practices.

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 constitutes uncomplicated intoxication?

Uncomplicated intoxication refers to the acute effects of substance use without the presence of severe withdrawal symptoms or complications that require intensive medical intervention.