MCMCB Pro
F16.229

F16.229Hallucinogen dependence with intoxication, unspecified

Billable / specific codeICD-10-CM

F16.229 is a billable, specific ICD-10-CM code for hallucinogen dependence with intoxication, unspecified. It is valid for submission on a claim.

Risk adjustment

F16.229 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

F16.229 is named in 12 Medicare coverage policies 9 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
  • A56645Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing

How F16.229 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 F16.229.

  • Dependencedrug NEChallucinogenwithintoxication
  • Disorderhallucinogen usemoderate or severewithother hallucinogen intoxication
  • Disorderphencyclidine usemoderate or severewithphencyclidine intoxication

Related codes at this level

Codes that share F16.22. If F16.229 is not quite right, the correct code is usually one of these.

Questions about F16.229

Is F16.229 a billable ICD-10-CM code?
Yes. F16.229 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does F16.229 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).
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.