F19.97 — Other psychoactive substance use, unspecified with psychoactive substance-induced persisting dementia
F19.97 is a billable, specific ICD-10-CM code for other psychoactive substance use, unspecified with psychoactive substance-induced persisting dementia. 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-induced major neurocognitive disorder, without use disorder
Risk adjustment
F19.97 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 135 Drug Use with 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
F19.97 is named in 13 Medicare coverage policies — 12 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
- A56645Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
- A56756Billing and Coding: Home Health - Psychiatric Care
- A56767Billing and Coding: Heavy Metal Testing
How F19.97 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 F19.97.
- Substance-induced›major neurocognitive disorder
- Dementia›in›psychoactive drug
- Disorder›cognitive›persisting›due to›specified substance NEC
- Use›psychoactive drug NEC›with›persisting›dementia
Related codes at this level
Codes that share F19.9. If F19.97 is not quite right, the correct code is usually one of these.
- F19.90Other psychoactive substance use, unspecified, uncomplicated
- F19.91Other psychoactive substance use, unspecified, in remission
- F19.92Other psychoactive substance use, unspecified with intoxication
- F19.93Other psychoactive substance use, unspecified with withdrawal
- F19.94Other psychoactive substance use, unspecified with psychoactive substance-induced mood disorder
- F19.95Other psychoactive substance use, unspecified with psychoactive substance-induced psychotic disorder
- F19.96Other psychoactive substance use, unspecified with psychoactive substance-induced persisting amnestic disorder
- F19.98Other psychoactive substance use, unspecified with other psychoactive substance-induced disorders
- F19.99Other psychoactive substance use, unspecified with unspecified psychoactive substance-induced disorder
Questions about F19.97
- Is F19.97 a billable ICD-10-CM code?
- Yes. F19.97 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does F19.97 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).