F16.91 — Hallucinogen use, unspecified, in remission
F16.91 is a billable, specific ICD-10-CM code for hallucinogen use, unspecified, in remission. It is valid for submission on a claim.
Risk adjustment
F16.91 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.
Medicare coverage
F16.91 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
- A56614Billing and Coding: Psychiatric Inpatient Hospitalization
How F16.91 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 F16.91.
- Use›hallucinogen NEC›in remission
Related codes at this level
Codes that share F16.9. If F16.91 is not quite right, the correct code is usually one of these.
- F16.90Hallucinogen use, unspecified, uncomplicated
- F16.92Hallucinogen use, unspecified with intoxication
- F16.94Hallucinogen use, unspecified with hallucinogen-induced mood disorder
- F16.95Hallucinogen use, unspecified with hallucinogen-induced psychotic disorder
- F16.98Hallucinogen use, unspecified with other specified hallucinogen-induced disorder
- F16.99Hallucinogen use, unspecified with unspecified hallucinogen-induced disorder
Questions about F16.91
- Is F16.91 a billable ICD-10-CM code?
- Yes. F16.91 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does F16.91 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).