F16.151 — Hallucinogen abuse with hallucinogen-induced psychotic disorder with hallucinations
F16.151 is a billable, specific ICD-10-CM code for hallucinogen abuse with hallucinogen-induced psychotic disorder with hallucinations. It is valid for submission on a claim.
Risk adjustment
F16.151 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 135 Drug Use with Psychotic Complications0.424 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.
Medicare coverage
F16.151 is named in 20 Medicare coverage policies — 17 listing it as supporting medical necessity, and 3 listing it as NOT covered. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52434Health and Behavior Assessment/Intervention – Medical Policy Articlenot covered
- A56562Billing and Coding: Health and Behavior Assessment/Interventionnot covered
- A59718Billing and Coding: Opioid Treatment Programsnot covered
- A56614Billing and Coding: Psychiatric Inpatient Hospitalization
How F16.151 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to F16.151.
- Hallucinosis›drug-induced›hallucinogen
- Hallucinosis›drug-induced›in›abuse›hallucinogen
- Abuse›drug NEC›hallucinogen›with›psychosis›hallucinations
Related codes at this level
Codes that share F16.15. If F16.151 is not quite right, the correct code is usually one of these.
Questions about F16.151
- Is F16.151 a billable ICD-10-CM code?
- Yes. F16.151 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does F16.151 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).