F19.20 — Other psychoactive substance dependence, uncomplicated
F19.20 is a billable, specific ICD-10-CM code for other psychoactive substance dependence, uncomplicated. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Other (or unknown) substance use disorder, moderate
- Other (or unknown) substance use disorder, severe
Risk adjustment
F19.20 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
F19.20 is named in 21 Medicare coverage policies — 20 listing it as supporting medical necessity, and 1 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
- A54799Billing and Coding: Urine Drug Testing
- A55001Billing and Coding: Urine Drug Testing
- A56645Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
How F19.20 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 F19.20.
- Addiction
- Dependence(on) (syndrome)
- Dependence›combinations of drugs
- Dependence›drug NEC
- Dependence›nitrous oxide
- Dependence›polysubstance
- Dependence›drug NEC›psychoactive NEC
- Dependence›ethyl›carbamate
- Dependence›ethyl›chloride
- Disorder›substance use›moderate or severe
Related codes at this level
Codes that share F19.2. If F19.20 is not quite right, the correct code is usually one of these.
- F19.21Other psychoactive substance dependence, in remission
- F19.22Other psychoactive substance dependence with intoxication
- F19.23Other psychoactive substance dependence with withdrawal
- F19.24Other psychoactive substance dependence with psychoactive substance-induced mood disorder
- F19.25Other psychoactive substance dependence with psychoactive substance-induced psychotic disorder
- F19.26Other psychoactive substance dependence with psychoactive substance-induced persisting amnestic disorder
- F19.27Other psychoactive substance dependence with psychoactive substance-induced persisting dementia
- F19.28Other psychoactive substance dependence with other psychoactive substance-induced disorders
- F19.29Other psychoactive substance dependence with unspecified psychoactive substance-induced disorder
Questions about F19.20
- Is F19.20 a billable ICD-10-CM code?
- Yes. F19.20 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does F19.20 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).