F16.188 — Hallucinogen abuse with other hallucinogen-induced disorder
F16.188 is a billable, specific ICD-10-CM code for hallucinogen abuse with other hallucinogen-induced disorder. It is valid for submission on a claim.
Risk adjustment
F16.188 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 137 Drug Use Disorder, Moderate/Severe, or Drug Use with Non-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
F16.188 is named in 19 Medicare coverage policies — 17 listing it as supporting medical necessity, and 2 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
- A59718Billing and Coding: Opioid Treatment Programsnot covered
- A56614Billing and Coding: Psychiatric Inpatient Hospitalization
- A56645Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
How F16.188 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 F16.188.
- Abuse›drug NEC›hallucinogen›with›other specified disorder
Related codes at this level
Codes that share F16.18. If F16.188 is not quite right, the correct code is usually one of these.
Questions about F16.188
- Is F16.188 a billable ICD-10-CM code?
- Yes. F16.188 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does F16.188 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).