MCMCB Pro
F16.1

F16.1Hallucinogen abuse

Non-billable headerICD-10-CM

F16.1 is a non-billable header ICD-10-CM code for hallucinogen abuse. It cannot be billed on its own: choose one of the more specific child codes below.

Excludes1 — never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

  • hallucinogen dependence (F16.2-)
  • hallucinogen use, unspecified (F16.9-)

Other codes that can never be billed with F16.1

These codes carry an Excludes1 note pointing at F16.1. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading F16.1 alone.

  • F16.2Hallucinogen dependence
  • F16.9Hallucinogen use, unspecified

Risk adjustment

F16.1 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Code to one of these instead F16.1

7 child codes. Green means billable.

Related codes at this level

Codes that share F16. If F16.1 is not quite right, the correct code is usually one of these.

Questions about F16.1

Is F16.1 a billable ICD-10-CM code?
No. F16.1 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does F16.1 sit in the tabular list?
Mental, Behavioral and Neurodevelopmental disorders (F01-F99), in the block Mental and behavioral disorders due to psychoactive substance use (F10-F19).
What cannot be coded together with F16.1?
F16.1 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.
ICD-10-CMFY2026-Apr· effective April 1, 2026

Loaded directly from the CMS/NCHS ICD-10-CM public-domain release — see data sources and our editorial policy. If this page disagrees with the CMS tabular list, this page is wrong. Reference information for professional coders; not medical or billing advice.