Oth psychoactv substance abuse w psych disorder w hallucin

This code signifies a patient's problematic pattern of use of a psychoactive substance (other than alcohol, opioids, cannabis, sedatives, hypnotics, anxiolytics, cocaine, or stimulants) leading to clinically significant impairment or distress, specifically manifesting as a psychotic disorder characterized by hallucinations directly induced by the substance. The abuse component indicates continued use despite adverse consequences, while the psychotic disorder with hallucinations is a direct physiological effect of the substance.

Apply this code when documentation clearly indicates abuse of an unspecified psychoactive substance (e.g., inhalants, hallucinogens not otherwise specified) and the patient presents with substance-induced hallucinations. This code is appropriate when the psychotic symptoms are determined to be a direct result of the substance's effects and resolve with cessation or reduction of the substance. Supporting documentation would include a detailed substance use history, mental status examination findings of hallucinations, and a physician's diagnostic statement linking the hallucinations to the substance abuse.

• Ensure the documentation specifies "abuse" rather than "dependence" or "use" to align with the .1 subcategory.
• Verify that the psychotic disorder is explicitly stated as "substance-induced" and includes "hallucinations" as the primary psychotic feature.
• Confirm that the psychoactive substance involved is not one with a more specific ICD-10-CM code (e.g., F10-F16, F18).