F19.188: Other psychoactive substance abuse with other psychoactive substance-induced disorder
F19.188 is a billable, specific ICD-10-CM code for other psychoactive substance abuse with other psychoactive substance-induced disorder. It is valid for submission on a claim.
Check F19.188 with the rest of the claim: free scrubberInclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Other (or unknown) substance use disorder, mild, with other (or unknown) substance induced mild neurocognitive disorder
- Other (or unknown) substance use disorder, mild, with other (or unknown) substance induced obsessive-compulsive or related disorder
Risk adjustment
F19.188 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. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
F19.188 is named in 19 Medicare coverage policies: 18 listing it as supporting medical necessity, and 1 listing it as NOT covered. Which one applies depends on your Medicare contractor.
- A52434Health and Behavior Assessment/Intervention – Medical Policy Articlenot covered
- A56614Billing and Coding: Psychiatric Inpatient Hospitalization
- A56645Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
- A56756Billing and Coding: Home Health - Psychiatric Care
Alphabetic index entries that lead here
- Abuse›drug NEC›psychoactive NEC›with›other specified disorder
- Disorder›substance use›mild›with substance-induced›mild neurocognitive disorder
- Disorder›substance use›mild›with substance-induced›obsessive-compulsive and related disorder
Code history
Unchanged in every release from FY2024 to FY2027.