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Health and Behavior Assessment/Intervention – Medical Policy Article

A52434

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Draft Article
Draft Articles are works in progress and not necessarily a reflection of the current billing and coding practices. Revisions to codes are carefully and thoroughly reviewed and are not intended to change the original intent of the LCD.
NOT AN LCD REFERENCE ARTICLE
This article is not in direct support of an LCD.

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Source Article ID
N/A
Article ID
A52434
Original ICD-9 Article ID
Not Applicable
Article Title
Health and Behavior Assessment/Intervention – Medical Policy Article
Article Type
Article
Original Effective Date
10/01/2015
Revision Effective Date
10/01/2024
Revision Ending Date
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Retirement Date
N/A

CPT codes, descriptions, and other data only are copyright 2023 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.

Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

Current Dental Terminology © 2023 American Dental Association. All rights reserved.

Copyright © 2024, the American Hospital Association, Chicago, Illinois. Reproduced with permission. No portion of the AHA copyrighted materials contained within this publication may be copied without the express written consent of the AHA. AHA copyrighted materials including the UB‐04 codes and descriptions may not be removed, copied, or utilized within any software, product, service, solution, or derivative work without the written consent of the AHA. If an entity wishes to utilize any AHA materials, please contact the AHA at 312‐893‐6816.

Making copies or utilizing the content of the UB‐04 Manual, including the codes and/or descriptions, for internal purposes, resale and/or to be used in any product or publication; creating any modified or derivative work of the UB‐04 Manual and/or codes and descriptions; and/or making any commercial use of UB‐04 Manual or any portion thereof, including the codes and/or descriptions, is only authorized with an express license from the American Hospital Association. The American Hospital Association (the "AHA") has not reviewed, and is not responsible for, the completeness or accuracy of any information contained in this material, nor was the AHA or any of its affiliates, involved in the preparation of this material, or the analysis of information provided in the material. The views and/or positions presented in the material do not necessarily represent the views of the AHA. CMS and its products and services are not endorsed by the AHA or any of its affiliates.

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Article Text

Abstract:

"Health and Behavior Assessment procedures are used to identify the psychological, behavioral, emotional, cognitive, and social factors important to the prevention, treatment or management of physical health problems. The focus of the assessment is not on mental health but on the biopsychosocial factors important to physical health problems and treatments." 1

Health and Behavior Intervention procedures are used to modify the psychological, behavioral, emotional, cognitive, and social factors directly affecting the patient's physiological functioning, health and well being, or specific disease-related problems.

Health Behavior Assessment and Intervention (HBAI) services described by CPT codes 96156, 96158, 96159, 96164, 96165, 96167, and 96168, and any successor codes, are billed by clinical social workers, marriage and family therapists (MFTs), and mental health counselors (MHCs), in addition to clinical psychologists.

Indications:

The Health and Behavioral Assessment, initial and Reassessment and Intervention services may be considered reasonable and necessary for the patient who meets all of the following criteria:

  1. The patient has an underlying physical illness or injury, and
  2. There are indications that biopsychosocial factors may be significantly affecting the treatment or medical management of an illness or an injury, and
  3. The patient is alert, oriented and has the capacity to understand and to respond meaningfully during the face-to-face encounter, and
  4. The patient has a documented need for psychological evaluation or intervention to successfully manage his/her physical illness, and activities of daily living, and
  5. The assessment is not duplicative of other provider assessments

In addition, for a reassessment to be considered reasonable and necessary, there must be documentation that there has been a sufficient change in the mental or medical status warranting re-evaluation of the patient's capacity to understand and cooperate with the medical interventions necessary to their health and well being.

Health and Behavioral Intervention, individual or group (2 or more patients) require that:

    1. Specific psychological intervention(s) and patient outcome goal(s) have been clearly identified, and
    2. Psychological intervention is necessary to address:
        • Non-compliance with the medical treatment plan, or
        • The biopsychosocial factors associated with a new diagnosed physical illness, or an exacerbation of an established physical illness, when such factors affect symptom management and expression, health-promoting behaviors, health-related risk-taking behaviors, and overall adjustment to medical illness.

Health and Behavioral Intervention (with the family and patient present) is considered reasonable and necessary for the patient who meets all of the following criteria:

  1. The family representative* directly participates in the overall care of the patient, and
  2. The psychological intervention with the patient and family is necessary to address biopsychosocial factors that affect compliance with the plan of care, symptom management, health-promoting behaviors, health-related risk-taking behaviors, and overall adjustment to medical illness.

*For the purpose of this policy, all references to a family representative is defined as immediate family members only (i.e., husband, wife, siblings, children, grandchildren, grandparents, mother, and father), any primary caregiver who provides care on a voluntary, uncompensated, regular and sustained basis, or a guardian or healthcare proxy.

Limitations:

Health and Behavioral Assessment/Intervention will not be considered reasonable and necessary for the patient who:

    1. Does not have an underlying physical illness or injury, or
    2. For whom there is no documented indication that a biopsychosocial factor may be significantly affecting the treatment, or medical management of an illness or injury (i.e., screening medical patient for psychological problems), or
    3. Does not have the capacity to understand and to respond meaningfully during the face to face encounter, because of:
        • Dementia that has produced a severe enough cognitive defect for the psychological intervention to be ineffective.
        • Delirium
        • Severe and profound mental retardation
        • Persistent vegetative state/no discernible consciousness,
        • Impaired mental status, e.g.,
          1. disorientation to person, time, place, purpose, or
          2. inability to recall current season, location of own room, names and faces, or
          3. inability to recall that he or she is in a nursing home or skilled nursing facility
          4. Does not require psychological support to successfully manage his/her physical illness through identification of the barriers to the management of physical disease and activities of daily living, or
          5. For whom the conditions noted under the indications portion of this section are not met.

Health and Behavioral Intervention with the family and patient present will not be considered reasonable and necessary for the patient if:

  1. It is not necessary to ensure patient compliance with the medical treatment plan, or
  2. The family representative does not directly participate in the plan of care, or
  3. The family representative is not present.
  4. There is no face to face encounter with the patient.

Because it does not represent a diagnostic or treatment service to the patient, there is no coverage for CPT codes 96170, 96171.

Health and Behavioral Intervention services are not considered reasonable and necessary to:

  1. Update or educate the family about the patient's condition
  2. Educate family members, primary care-givers, guardians, the health care proxy, or other members of the treatment team, e.g., health aides, nurses, physical or occupational therapists, home health aides, personal care attendants and co-workers about the patient's care plan.
  3. Assist in treatment-planning with staff
  4. Provide family psychotherapy or mediation
  5. Educate diabetic patients and diabetic patients' family members
  6. Deliver Medical Nutrition Therapy
  7. Maintain the patient's or family's existing health and overall well-being
  8. Provide personal, social, recreational, and general support services. Although such services may be valuable adjuncts to care, they are not medically necessary psychological interventions.

Examples of services not covered as health and behavioral interventions are:

  • Stress management for support staff
  • Replacement for expected nursing home staff functions
  • Music appreciation and relaxation
  • Craft skill training
  • Cooking classes
  • Comfort care services
  • Individual social activities
  • Teaching social interaction skills
  • Socialization in a group setting
  • Retraining cognition due to dementia
  • General conversation
  • Services directed toward making a more dynamic personality
  • Consciousness raising
  • Vocational or religious advice
  • General educational activities
  • Tobacco or caffeine withdrawal support
  • Visits for loneliness relief
  • Sensory stimulation
  • Games, including bingo games
  • Projects, including letter writing
  • Entertainment and diversionary activities
  • Excursions, including shopping outings, even when used to reduce a dysphoric state
  • Teaching grooming skills
  • Grooming services
  • Monitoring activities of daily living
  • Teaching the patient simple self-care
  • Teaching the patient to follow simple directives
  • Wheeling the patient around the facility
  • Orienting the patient to name, date, and place
  • Exercise programs, even when designed to reduce a dysphoric state
  • Memory enhancement training
  • Weight loss management
  • Case management services including but not limited to planning activities of daily living, arranging care or excursions, or resolving insurance problems
  • Activities principally for diversion
  • Planning for milieu modifications
  • Contributions to patient care plans
  • Maintenance of behavioral logs

Biofeedback is coded as 90901 and will not be covered as a health and behavioral intervention.

Coding Information:

Procedure codes may be subject to National Correct Coding Initiative (NCCI) edits or OPPS packaging edits. Refer to NCCI and OPPS requirements prior to billing Medicare.

For services requiring a referring/ordering physician, the name and NPI of the referring/ordering physician must be reported on the claim.

A claim submitted without a valid ICD-10-CM diagnosis code will be returned to the provider as an incomplete claim under Section 1833(e) of the Social Security Act.

The diagnosis code(s) must describe the patient's condition for which the service was performed.

Advance Beneficiary Notice of Noncoverage (ABN) Modifier Guidelines An ABN may be used for services which are likely to be non-covered, whether for medical necessity or for other reasons. Refer to CMS Publication 100-04, Medicare Claims Processing Manual, Chapter 30, for complete instructions.

If the initial health and behavior assessment or reassessment is unable to be completed during a single encounter, the date of service indicated on the claim should be the date on which the interview was finalized.

For health and behavior assessment and/or intervention services performed by a physician, clinical nurse specialist (CNS), or nurse practitioner (NP), Evaluation and Management (E&M) or Preventive Medicine services codes should be used.

Services to patients for evaluation and treatment of mental illnesses should be coded using a psychiatric services CPT code (90791-90899).

For patients that require psychiatric services (CPT codes 90791-90899) as well as health and behavior assessment/intervention (96156, 96167, 96168), report the predominant service performed.

The patient's medical record must contain documentation that fully supports the medical necessity for services included within this LCD. (See "Indications and Limitations of Coverage.") This documentation includes, but is not limited to, relevant medical history, physical examination, and results of pertinent diagnostic tests or procedures.

Each claim must be submitted with ICD-10-CM codes that reflect the condition of the patient, and indicate the reason(s) for which the service was performed. Claims submitted without ICD-10-CM codes will be returned.

Because of the impact on the medical management of the patient's disease, documentation must show evidence of coordination of care with the patient's primary medical care providers or medical provider responsible for the medical management of the physical illness that the psychological assessment/intervention was meant to address.

Documentation in the medical record must include:

a. For the initial assessment, evidence to support that the assessment is reasonable and necessary, and must include, at a minimum, the following elements:

  • Date of initial diagnosis of physical illness, and
  • Clear rationale for why assessment is required, and
  • Assessment outcome including mental status and ability to understand and respond meaningfully, and
  • Goals and expected duration of specific psychological intervention(s), if recommended.

b. For re-assessment, detailed progress notes to support that the reassessment is reasonable and necessary must include the following elements:

  • Date of change in mental or physical status
  • Sufficient rationale for why re-assessment is required, and,
  • Clear indication of any precipitating events that necessitate re-assessment

c. For the intervention service, evidence to support that the intervention is reasonable and necessary must include, at a minimum, the following elements:

  • Evidence that the patient has the capacity to understand and to respond meaningfully
  • Clearly defined psychological intervention planned
  • The goals of the psychological intervention
  • The expectation that the psychological intervention will improve compliance with the medical treatment plan
  • The response to the intervention
  • Rationale for frequency and duration of services

For all claims, the time duration (stated in minutes) spent in the health and behavioral assessment or intervention encounter must be documented in the record.

Documentation must be available to Medicare upon request.

Sources of Information:

This bibliography presents those sources that were obtained during the development of this policy. National Government Services is not responsible for the continuing viability of Web site addresses listed below.

  • Current Procedural Terminology, CPT 2009
  • Program Memorandum, Expanded Coverage of Diabetes Outpatient Self-Management Training, CR 1455, June 15, 2001
  • Program Memorandum, Medical Nutrition Therapy for Beneficiaries with Diabetes or Renal Disease, CR 1776, August 7, 2001
  • Carrier Advisory Committee Psychiatry Working Group
  • CPT Changes, "An Insider's View", 2002, American Medical Association, pages 218-220.

 

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ICD-10-CM Codes that DO NOT Support Medical Necessity

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Group 1

(890 Codes)
Group 1 Paragraph

N/A

 Group 1 Codes
Code Description
F01.50 Vascular dementia, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
F01.511 Vascular dementia, unspecified severity, with agitation
F01.518 Vascular dementia, unspecified severity, with other behavioral disturbance
F01.52 Vascular dementia, unspecified severity, with psychotic disturbance
F01.53 Vascular dementia, unspecified severity, with mood disturbance
F01.54 Vascular dementia, unspecified severity, with anxiety
F01.A0 Vascular dementia, mild, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
F01.A11 Vascular dementia, mild, with agitation
F01.A18 Vascular dementia, mild, with other behavioral disturbance
F01.A2 Vascular dementia, mild, with psychotic disturbance
F01.A3 Vascular dementia, mild, with mood disturbance
F01.A4 Vascular dementia, mild, with anxiety
F01.B0 Vascular dementia, moderate, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
F01.B11 Vascular dementia, moderate, with agitation
F01.B18 Vascular dementia, moderate, with other behavioral disturbance
F01.B2 Vascular dementia, moderate, with psychotic disturbance
F01.B3 Vascular dementia, moderate, with mood disturbance
F01.B4 Vascular dementia, moderate, with anxiety
F01.C0 Vascular dementia, severe, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
F01.C11 Vascular dementia, severe, with agitation
F01.C18 Vascular dementia, severe, with other behavioral disturbance
F01.C2 Vascular dementia, severe, with psychotic disturbance
F01.C3 Vascular dementia, severe, with mood disturbance
F01.C4 Vascular dementia, severe, with anxiety
F02.80 Dementia in other diseases classified elsewhere, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
F02.811 Dementia in other diseases classified elsewhere, unspecified severity, with agitation
F02.818 Dementia in other diseases classified elsewhere, unspecified severity, with other behavioral disturbance
F02.82 Dementia in other diseases classified elsewhere, unspecified severity, with psychotic disturbance
F02.83 Dementia in other diseases classified elsewhere, unspecified severity, with mood disturbance
F02.84 Dementia in other diseases classified elsewhere, unspecified severity, with anxiety
F02.A0 Dementia in other diseases classified elsewhere, mild, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
F02.A11 Dementia in other diseases classified elsewhere, mild, with agitation
F02.A18 Dementia in other diseases classified elsewhere, mild, with other behavioral disturbance
F02.A2 Dementia in other diseases classified elsewhere, mild, with psychotic disturbance
F02.A3 Dementia in other diseases classified elsewhere, mild, with mood disturbance
F02.A4 Dementia in other diseases classified elsewhere, mild, with anxiety
F02.B0 Dementia in other diseases classified elsewhere, moderate, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
F02.B11 Dementia in other diseases classified elsewhere, moderate, with agitation
F02.B18 Dementia in other diseases classified elsewhere, moderate, with other behavioral disturbance
F02.B2 Dementia in other diseases classified elsewhere, moderate, with psychotic disturbance
F02.B3 Dementia in other diseases classified elsewhere, moderate, with mood disturbance
F02.B4 Dementia in other diseases classified elsewhere, moderate, with anxiety
F02.C0 Dementia in other diseases classified elsewhere, severe, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
F02.C11 Dementia in other diseases classified elsewhere, severe, with agitation
F02.C18 Dementia in other diseases classified elsewhere, severe, with other behavioral disturbance
F02.C2 Dementia in other diseases classified elsewhere, severe, with psychotic disturbance
F02.C3 Dementia in other diseases classified elsewhere, severe, with mood disturbance
F02.C4 Dementia in other diseases classified elsewhere, severe, with anxiety
F03.90 Unspecified dementia, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
F03.911 Unspecified dementia, unspecified severity, with agitation
F03.918 Unspecified dementia, unspecified severity, with other behavioral disturbance
F03.92 Unspecified dementia, unspecified severity, with psychotic disturbance
F03.93 Unspecified dementia, unspecified severity, with mood disturbance
F03.94 Unspecified dementia, unspecified severity, with anxiety
F03.A0 Unspecified dementia, mild, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
F03.A11 Unspecified dementia, mild, with agitation
F03.A18 Unspecified dementia, mild, with other behavioral disturbance
F03.A2 Unspecified dementia, mild, with psychotic disturbance
F03.A3 Unspecified dementia, mild, with mood disturbance
F03.A4 Unspecified dementia, mild, with anxiety
F03.B0 Unspecified dementia, moderate, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
F03.B11 Unspecified dementia, moderate, with agitation
F03.B18 Unspecified dementia, moderate, with other behavioral disturbance
F03.B2 Unspecified dementia, moderate, with psychotic disturbance
F03.B3 Unspecified dementia, moderate, with mood disturbance
F03.B4 Unspecified dementia, moderate, with anxiety
F03.C0 Unspecified dementia, severe, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
F03.C11 Unspecified dementia, severe, with agitation
F03.C18 Unspecified dementia, severe, with other behavioral disturbance
F03.C2 Unspecified dementia, severe, with psychotic disturbance
F03.C3 Unspecified dementia, severe, with mood disturbance
F03.C4 Unspecified dementia, severe, with anxiety
F04 Amnestic disorder due to known physiological condition
F05 Delirium due to known physiological condition
F06.0 Psychotic disorder with hallucinations due to known physiological condition
F06.1 Catatonic disorder due to known physiological condition
F06.2 Psychotic disorder with delusions due to known physiological condition
F06.30 Mood disorder due to known physiological condition, unspecified
F06.31 Mood disorder due to known physiological condition with depressive features
F06.32 Mood disorder due to known physiological condition with major depressive-like episode
F06.33 Mood disorder due to known physiological condition with manic features
F06.34 Mood disorder due to known physiological condition with mixed features
F06.4 Anxiety disorder due to known physiological condition
F06.70 Mild neurocognitive disorder due to known physiological condition without behavioral disturbance
F06.71 Mild neurocognitive disorder due to known physiological condition with behavioral disturbance
F06.8 Other specified mental disorders due to known physiological condition
F07.0 Personality change due to known physiological condition
F07.81 Postconcussional syndrome
F07.89 Other personality and behavioral disorders due to known physiological condition
F07.9 Unspecified personality and behavioral disorder due to known physiological condition
F09 Unspecified mental disorder due to known physiological condition
F10.10 Alcohol abuse, uncomplicated
F10.11 Alcohol abuse, in remission
F10.120 Alcohol abuse with intoxication, uncomplicated
F10.121 Alcohol abuse with intoxication delirium
F10.129 Alcohol abuse with intoxication, unspecified
F10.130 Alcohol abuse with withdrawal, uncomplicated
F10.131 Alcohol abuse with withdrawal delirium
F10.132 Alcohol abuse with withdrawal with perceptual disturbance
F10.139 Alcohol abuse with withdrawal, unspecified
F10.14 Alcohol abuse with alcohol-induced mood disorder
F10.150 Alcohol abuse with alcohol-induced psychotic disorder with delusions
F10.151 Alcohol abuse with alcohol-induced psychotic disorder with hallucinations
F10.159 Alcohol abuse with alcohol-induced psychotic disorder, unspecified
F10.180 Alcohol abuse with alcohol-induced anxiety disorder
F10.181 Alcohol abuse with alcohol-induced sexual dysfunction
F10.182 Alcohol abuse with alcohol-induced sleep disorder
F10.188 Alcohol abuse with other alcohol-induced disorder
F10.19 Alcohol abuse with unspecified alcohol-induced disorder
F10.20 Alcohol dependence, uncomplicated
F10.21 Alcohol dependence, in remission
F10.220 Alcohol dependence with intoxication, uncomplicated
F10.221 Alcohol dependence with intoxication delirium
F10.229 Alcohol dependence with intoxication, unspecified
F10.230 Alcohol dependence with withdrawal, uncomplicated
F10.231 Alcohol dependence with withdrawal delirium
F10.232 Alcohol dependence with withdrawal with perceptual disturbance
F10.239 Alcohol dependence with withdrawal, unspecified
F10.24 Alcohol dependence with alcohol-induced mood disorder
F10.250 Alcohol dependence with alcohol-induced psychotic disorder with delusions
F10.251 Alcohol dependence with alcohol-induced psychotic disorder with hallucinations
F10.259 Alcohol dependence with alcohol-induced psychotic disorder, unspecified
F10.26 Alcohol dependence with alcohol-induced persisting amnestic disorder
F10.27 Alcohol dependence with alcohol-induced persisting dementia
F10.280 Alcohol dependence with alcohol-induced anxiety disorder
F10.281 Alcohol dependence with alcohol-induced sexual dysfunction
F10.282 Alcohol dependence with alcohol-induced sleep disorder
F10.288 Alcohol dependence with other alcohol-induced disorder
F10.29 Alcohol dependence with unspecified alcohol-induced disorder
F10.90 Alcohol use, unspecified, uncomplicated
F10.91 Alcohol use, unspecified, in remission
F10.920 Alcohol use, unspecified with intoxication, uncomplicated
F10.921 Alcohol use, unspecified with intoxication delirium
F10.929 Alcohol use, unspecified with intoxication, unspecified
F10.930 Alcohol use, unspecified with withdrawal, uncomplicated
F10.931 Alcohol use, unspecified with withdrawal delirium
F10.932 Alcohol use, unspecified with withdrawal with perceptual disturbance
F10.939 Alcohol use, unspecified with withdrawal, unspecified
F10.94 Alcohol use, unspecified with alcohol-induced mood disorder
F10.950 Alcohol use, unspecified with alcohol-induced psychotic disorder with delusions
F10.951 Alcohol use, unspecified with alcohol-induced psychotic disorder with hallucinations
F10.959 Alcohol use, unspecified with alcohol-induced psychotic disorder, unspecified
F10.96 Alcohol use, unspecified with alcohol-induced persisting amnestic disorder
F10.97 Alcohol use, unspecified with alcohol-induced persisting dementia
F10.980 Alcohol use, unspecified with alcohol-induced anxiety disorder
F10.981 Alcohol use, unspecified with alcohol-induced sexual dysfunction
F10.982 Alcohol use, unspecified with alcohol-induced sleep disorder
F10.988 Alcohol use, unspecified with other alcohol-induced disorder
F10.99 Alcohol use, unspecified with unspecified alcohol-induced disorder
F11.10 Opioid abuse, uncomplicated
F11.11 Opioid abuse, in remission
F11.120 Opioid abuse with intoxication, uncomplicated
F11.121 Opioid abuse with intoxication delirium
F11.122 Opioid abuse with intoxication with perceptual disturbance
F11.129 Opioid abuse with intoxication, unspecified
F11.13 Opioid abuse with withdrawal
F11.14 Opioid abuse with opioid-induced mood disorder
F11.150 Opioid abuse with opioid-induced psychotic disorder with delusions
F11.151 Opioid abuse with opioid-induced psychotic disorder with hallucinations
F11.159 Opioid abuse with opioid-induced psychotic disorder, unspecified
F11.181 Opioid abuse with opioid-induced sexual dysfunction
F11.182 Opioid abuse with opioid-induced sleep disorder
F11.188 Opioid abuse with other opioid-induced disorder
F11.19 Opioid abuse with unspecified opioid-induced disorder
F11.20 Opioid dependence, uncomplicated
F11.21 Opioid dependence, in remission
F11.220 Opioid dependence with intoxication, uncomplicated
F11.221 Opioid dependence with intoxication delirium
F11.222 Opioid dependence with intoxication with perceptual disturbance
F11.229 Opioid dependence with intoxication, unspecified
F11.23 Opioid dependence with withdrawal
F11.24 Opioid dependence with opioid-induced mood disorder
F11.250 Opioid dependence with opioid-induced psychotic disorder with delusions
F11.251 Opioid dependence with opioid-induced psychotic disorder with hallucinations
F11.259 Opioid dependence with opioid-induced psychotic disorder, unspecified
F11.281 Opioid dependence with opioid-induced sexual dysfunction
F11.282 Opioid dependence with opioid-induced sleep disorder
F11.288 Opioid dependence with other opioid-induced disorder
F11.29 Opioid dependence with unspecified opioid-induced disorder
F11.90 Opioid use, unspecified, uncomplicated
F11.91 Opioid use, unspecified, in remission
F11.920 Opioid use, unspecified with intoxication, uncomplicated
F11.921 Opioid use, unspecified with intoxication delirium
F11.922 Opioid use, unspecified with intoxication with perceptual disturbance
F11.929 Opioid use, unspecified with intoxication, unspecified
F11.93 Opioid use, unspecified with withdrawal
F11.94 Opioid use, unspecified with opioid-induced mood disorder
F11.950 Opioid use, unspecified with opioid-induced psychotic disorder with delusions
F11.951 Opioid use, unspecified with opioid-induced psychotic disorder with hallucinations
F11.959 Opioid use, unspecified with opioid-induced psychotic disorder, unspecified
F11.981 Opioid use, unspecified with opioid-induced sexual dysfunction
F11.982 Opioid use, unspecified with opioid-induced sleep disorder
F11.988 Opioid use, unspecified with other opioid-induced disorder
F11.99 Opioid use, unspecified with unspecified opioid-induced disorder
F12.10 Cannabis abuse, uncomplicated
F12.11 Cannabis abuse, in remission
F12.120 Cannabis abuse with intoxication, uncomplicated
F12.121 Cannabis abuse with intoxication delirium
F12.122 Cannabis abuse with intoxication with perceptual disturbance
F12.129 Cannabis abuse with intoxication, unspecified
F12.13 Cannabis abuse with withdrawal
F12.150 Cannabis abuse with psychotic disorder with delusions
F12.151 Cannabis abuse with psychotic disorder with hallucinations
F12.159 Cannabis abuse with psychotic disorder, unspecified
F12.180 Cannabis abuse with cannabis-induced anxiety disorder
F12.188 Cannabis abuse with other cannabis-induced disorder
F12.19 Cannabis abuse with unspecified cannabis-induced disorder
F12.20 Cannabis dependence, uncomplicated
F12.21 Cannabis dependence, in remission
F12.220 Cannabis dependence with intoxication, uncomplicated
F12.221 Cannabis dependence with intoxication delirium
F12.222 Cannabis dependence with intoxication with perceptual disturbance
F12.229 Cannabis dependence with intoxication, unspecified
F12.23 Cannabis dependence with withdrawal
F12.250 Cannabis dependence with psychotic disorder with delusions
F12.251 Cannabis dependence with psychotic disorder with hallucinations
F12.259 Cannabis dependence with psychotic disorder, unspecified
F12.280 Cannabis dependence with cannabis-induced anxiety disorder
F12.288 Cannabis dependence with other cannabis-induced disorder
F12.29 Cannabis dependence with unspecified cannabis-induced disorder
F12.90 Cannabis use, unspecified, uncomplicated
F12.91 Cannabis use, unspecified, in remission
F12.920 Cannabis use, unspecified with intoxication, uncomplicated
F12.921 Cannabis use, unspecified with intoxication delirium
F12.922 Cannabis use, unspecified with intoxication with perceptual disturbance
F12.929 Cannabis use, unspecified with intoxication, unspecified
F12.93 Cannabis use, unspecified with withdrawal
F12.950 Cannabis use, unspecified with psychotic disorder with delusions
F12.951 Cannabis use, unspecified with psychotic disorder with hallucinations
F12.959 Cannabis use, unspecified with psychotic disorder, unspecified
F12.980 Cannabis use, unspecified with anxiety disorder
F12.988 Cannabis use, unspecified with other cannabis-induced disorder
F12.99 Cannabis use, unspecified with unspecified cannabis-induced disorder
F13.10 Sedative, hypnotic or anxiolytic abuse, uncomplicated
F13.11 Sedative, hypnotic or anxiolytic abuse, in remission
F13.120 Sedative, hypnotic or anxiolytic abuse with intoxication, uncomplicated
F13.121 Sedative, hypnotic or anxiolytic abuse with intoxication delirium
F13.129 Sedative, hypnotic or anxiolytic abuse with intoxication, unspecified
F13.130 Sedative, hypnotic or anxiolytic abuse with withdrawal, uncomplicated
F13.131 Sedative, hypnotic or anxiolytic abuse with withdrawal delirium
F13.132 Sedative, hypnotic or anxiolytic abuse with withdrawal with perceptual disturbance
F13.139 Sedative, hypnotic or anxiolytic abuse with withdrawal, unspecified
F13.14 Sedative, hypnotic or anxiolytic abuse with sedative, hypnotic or anxiolytic-induced mood disorder
F13.150 Sedative, hypnotic or anxiolytic abuse with sedative, hypnotic or anxiolytic-induced psychotic disorder with delusions
F13.151 Sedative, hypnotic or anxiolytic abuse with sedative, hypnotic or anxiolytic-induced psychotic disorder with hallucinations
F13.159 Sedative, hypnotic or anxiolytic abuse with sedative, hypnotic or anxiolytic-induced psychotic disorder, unspecified
F13.180 Sedative, hypnotic or anxiolytic abuse with sedative, hypnotic or anxiolytic-induced anxiety disorder
F13.181 Sedative, hypnotic or anxiolytic abuse with sedative, hypnotic or anxiolytic-induced sexual dysfunction
F13.182 Sedative, hypnotic or anxiolytic abuse with sedative, hypnotic or anxiolytic-induced sleep disorder
F13.188 Sedative, hypnotic or anxiolytic abuse with other sedative, hypnotic or anxiolytic-induced disorder
F13.19 Sedative, hypnotic or anxiolytic abuse with unspecified sedative, hypnotic or anxiolytic-induced disorder
F13.20 Sedative, hypnotic or anxiolytic dependence, uncomplicated
F13.21 Sedative, hypnotic or anxiolytic dependence, in remission
F13.220 Sedative, hypnotic or anxiolytic dependence with intoxication, uncomplicated
F13.221 Sedative, hypnotic or anxiolytic dependence with intoxication delirium
F13.229 Sedative, hypnotic or anxiolytic dependence with intoxication, unspecified
F13.230 Sedative, hypnotic or anxiolytic dependence with withdrawal, uncomplicated
F13.231 Sedative, hypnotic or anxiolytic dependence with withdrawal delirium
F13.232 Sedative, hypnotic or anxiolytic dependence with withdrawal with perceptual disturbance
F13.239 Sedative, hypnotic or anxiolytic dependence with withdrawal, unspecified
F13.24 Sedative, hypnotic or anxiolytic dependence with sedative, hypnotic or anxiolytic-induced mood disorder
F13.250 Sedative, hypnotic or anxiolytic dependence with sedative, hypnotic or anxiolytic-induced psychotic disorder with delusions
F13.251 Sedative, hypnotic or anxiolytic dependence with sedative, hypnotic or anxiolytic-induced psychotic disorder with hallucinations
F13.259 Sedative, hypnotic or anxiolytic dependence with sedative, hypnotic or anxiolytic-induced psychotic disorder, unspecified
F13.26 Sedative, hypnotic or anxiolytic dependence with sedative, hypnotic or anxiolytic-induced persisting amnestic disorder
F13.27 Sedative, hypnotic or anxiolytic dependence with sedative, hypnotic or anxiolytic-induced persisting dementia
F13.280 Sedative, hypnotic or anxiolytic dependence with sedative, hypnotic or anxiolytic-induced anxiety disorder
F13.281 Sedative, hypnotic or anxiolytic dependence with sedative, hypnotic or anxiolytic-induced sexual dysfunction
F13.282 Sedative, hypnotic or anxiolytic dependence with sedative, hypnotic or anxiolytic-induced sleep disorder
F13.288 Sedative, hypnotic or anxiolytic dependence with other sedative, hypnotic or anxiolytic-induced disorder
F13.29 Sedative, hypnotic or anxiolytic dependence with unspecified sedative, hypnotic or anxiolytic-induced disorder
F13.90 Sedative, hypnotic, or anxiolytic use, unspecified, uncomplicated
F13.91 Sedative, hypnotic or anxiolytic use, unspecified, in remission
F13.920 Sedative, hypnotic or anxiolytic use, unspecified with intoxication, uncomplicated
F13.921 Sedative, hypnotic or anxiolytic use, unspecified with intoxication delirium
F13.929 Sedative, hypnotic or anxiolytic use, unspecified with intoxication, unspecified
F13.930 Sedative, hypnotic or anxiolytic use, unspecified with withdrawal, uncomplicated
F13.931 Sedative, hypnotic or anxiolytic use, unspecified with withdrawal delirium
F13.932 Sedative, hypnotic or anxiolytic use, unspecified with withdrawal with perceptual disturbances
F13.939 Sedative, hypnotic or anxiolytic use, unspecified with withdrawal, unspecified
F13.94 Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced mood disorder
F13.950 Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced psychotic disorder with delusions
F13.951 Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced psychotic disorder with hallucinations
F13.959 Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced psychotic disorder, unspecified
F13.96 Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced persisting amnestic disorder
F13.97 Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced persisting dementia
F13.980 Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced anxiety disorder
F13.981 Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced sexual dysfunction
F13.982 Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced sleep disorder
F13.988 Sedative, hypnotic or anxiolytic use, unspecified with other sedative, hypnotic or anxiolytic-induced disorder
F13.99 Sedative, hypnotic or anxiolytic use, unspecified with unspecified sedative, hypnotic or anxiolytic-induced disorder
F14.10 Cocaine abuse, uncomplicated
F14.11 Cocaine abuse, in remission
F14.120 Cocaine abuse with intoxication, uncomplicated
F14.121 Cocaine abuse with intoxication with delirium
F14.122 Cocaine abuse with intoxication with perceptual disturbance
F14.129 Cocaine abuse with intoxication, unspecified
F14.13 Cocaine abuse, unspecified with withdrawal
F14.14 Cocaine abuse with cocaine-induced mood disorder
F14.150 Cocaine abuse with cocaine-induced psychotic disorder with delusions
F14.151 Cocaine abuse with cocaine-induced psychotic disorder with hallucinations
F14.159 Cocaine abuse with cocaine-induced psychotic disorder, unspecified
F14.180 Cocaine abuse with cocaine-induced anxiety disorder
F14.181 Cocaine abuse with cocaine-induced sexual dysfunction
F14.182 Cocaine abuse with cocaine-induced sleep disorder
F14.188 Cocaine abuse with other cocaine-induced disorder
F14.19 Cocaine abuse with unspecified cocaine-induced disorder
F14.20 Cocaine dependence, uncomplicated
F14.21 Cocaine dependence, in remission
F14.220 Cocaine dependence with intoxication, uncomplicated
F14.221 Cocaine dependence with intoxication delirium
F14.222 Cocaine dependence with intoxication with perceptual disturbance
F14.229 Cocaine dependence with intoxication, unspecified
F14.23 Cocaine dependence with withdrawal
F14.24 Cocaine dependence with cocaine-induced mood disorder
F14.250 Cocaine dependence with cocaine-induced psychotic disorder with delusions
F14.251 Cocaine dependence with cocaine-induced psychotic disorder with hallucinations
F14.259 Cocaine dependence with cocaine-induced psychotic disorder, unspecified
F14.280 Cocaine dependence with cocaine-induced anxiety disorder
F14.281 Cocaine dependence with cocaine-induced sexual dysfunction
F14.282 Cocaine dependence with cocaine-induced sleep disorder
F14.288 Cocaine dependence with other cocaine-induced disorder
F14.29 Cocaine dependence with unspecified cocaine-induced disorder
F14.90 Cocaine use, unspecified, uncomplicated
F14.91 Cocaine use, unspecified, in remission
F14.920 Cocaine use, unspecified with intoxication, uncomplicated
F14.921 Cocaine use, unspecified with intoxication delirium
F14.922 Cocaine use, unspecified with intoxication with perceptual disturbance
F14.929 Cocaine use, unspecified with intoxication, unspecified
F14.93 Cocaine use, unspecified with withdrawal
F14.94 Cocaine use, unspecified with cocaine-induced mood disorder
F14.950 Cocaine use, unspecified with cocaine-induced psychotic disorder with delusions
F14.951 Cocaine use, unspecified with cocaine-induced psychotic disorder with hallucinations
F14.959 Cocaine use, unspecified with cocaine-induced psychotic disorder, unspecified
F14.980 Cocaine use, unspecified with cocaine-induced anxiety disorder
F14.981 Cocaine use, unspecified with cocaine-induced sexual dysfunction
F14.982 Cocaine use, unspecified with cocaine-induced sleep disorder
F14.988 Cocaine use, unspecified with other cocaine-induced disorder
F14.99 Cocaine use, unspecified with unspecified cocaine-induced disorder
F15.10 Other stimulant abuse, uncomplicated
F15.11 Other stimulant abuse, in remission
F15.120 Other stimulant abuse with intoxication, uncomplicated
F15.121 Other stimulant abuse with intoxication delirium
F15.122 Other stimulant abuse with intoxication with perceptual disturbance
F15.129 Other stimulant abuse with intoxication, unspecified
F15.13 Other stimulant abuse with withdrawal
F15.14 Other stimulant abuse with stimulant-induced mood disorder
F15.150 Other stimulant abuse with stimulant-induced psychotic disorder with delusions
F15.151 Other stimulant abuse with stimulant-induced psychotic disorder with hallucinations
F15.159 Other stimulant abuse with stimulant-induced psychotic disorder, unspecified
F15.180 Other stimulant abuse with stimulant-induced anxiety disorder
F15.181 Other stimulant abuse with stimulant-induced sexual dysfunction
F15.182 Other stimulant abuse with stimulant-induced sleep disorder
F15.188 Other stimulant abuse with other stimulant-induced disorder
F15.19 Other stimulant abuse with unspecified stimulant-induced disorder
F15.20 Other stimulant dependence, uncomplicated
F15.21 Other stimulant dependence, in remission
F15.220 Other stimulant dependence with intoxication, uncomplicated
F15.221 Other stimulant dependence with intoxication delirium
F15.222 Other stimulant dependence with intoxication with perceptual disturbance
F15.229 Other stimulant dependence with intoxication, unspecified
F15.23 Other stimulant dependence with withdrawal
F15.24 Other stimulant dependence with stimulant-induced mood disorder
F15.250 Other stimulant dependence with stimulant-induced psychotic disorder with delusions
F15.251 Other stimulant dependence with stimulant-induced psychotic disorder with hallucinations
F15.259 Other stimulant dependence with stimulant-induced psychotic disorder, unspecified
F15.280 Other stimulant dependence with stimulant-induced anxiety disorder
F15.281 Other stimulant dependence with stimulant-induced sexual dysfunction
F15.282 Other stimulant dependence with stimulant-induced sleep disorder
F15.288 Other stimulant dependence with other stimulant-induced disorder
F15.29 Other stimulant dependence with unspecified stimulant-induced disorder
F15.90 Other stimulant use, unspecified, uncomplicated
F15.91 Other stimulant use, unspecified, in remission
F15.920 Other stimulant use, unspecified with intoxication, uncomplicated
F15.921 Other stimulant use, unspecified with intoxication delirium
F15.922 Other stimulant use, unspecified with intoxication with perceptual disturbance
F15.929 Other stimulant use, unspecified with intoxication, unspecified
F15.93 Other stimulant use, unspecified with withdrawal
F15.94 Other stimulant use, unspecified with stimulant-induced mood disorder
F15.950 Other stimulant use, unspecified with stimulant-induced psychotic disorder with delusions
F15.951 Other stimulant use, unspecified with stimulant-induced psychotic disorder with hallucinations
F15.959 Other stimulant use, unspecified with stimulant-induced psychotic disorder, unspecified
F15.980 Other stimulant use, unspecified with stimulant-induced anxiety disorder
F15.981 Other stimulant use, unspecified with stimulant-induced sexual dysfunction
F15.982 Other stimulant use, unspecified with stimulant-induced sleep disorder
F15.988 Other stimulant use, unspecified with other stimulant-induced disorder
F15.99 Other stimulant use, unspecified with unspecified stimulant-induced disorder
F16.10 Hallucinogen abuse, uncomplicated
F16.11 Hallucinogen abuse, in remission
F16.120 Hallucinogen abuse with intoxication, uncomplicated
F16.121 Hallucinogen abuse with intoxication with delirium
F16.122 Hallucinogen abuse with intoxication with perceptual disturbance
F16.129 Hallucinogen abuse with intoxication, unspecified
F16.14 Hallucinogen abuse with hallucinogen-induced mood disorder
F16.150 Hallucinogen abuse with hallucinogen-induced psychotic disorder with delusions
F16.151 Hallucinogen abuse with hallucinogen-induced psychotic disorder with hallucinations
F16.159 Hallucinogen abuse with hallucinogen-induced psychotic disorder, unspecified
F16.180 Hallucinogen abuse with hallucinogen-induced anxiety disorder
F16.183 Hallucinogen abuse with hallucinogen persisting perception disorder (flashbacks)
F16.188 Hallucinogen abuse with other hallucinogen-induced disorder
F16.19 Hallucinogen abuse with unspecified hallucinogen-induced disorder
F16.20 Hallucinogen dependence, uncomplicated
F16.21 Hallucinogen dependence, in remission
F16.220 Hallucinogen dependence with intoxication, uncomplicated
F16.221 Hallucinogen dependence with intoxication with delirium
F16.229 Hallucinogen dependence with intoxication, unspecified
F16.24 Hallucinogen dependence with hallucinogen-induced mood disorder
F16.250 Hallucinogen dependence with hallucinogen-induced psychotic disorder with delusions
F16.251 Hallucinogen dependence with hallucinogen-induced psychotic disorder with hallucinations
F16.259 Hallucinogen dependence with hallucinogen-induced psychotic disorder, unspecified
F16.280 Hallucinogen dependence with hallucinogen-induced anxiety disorder
F16.283 Hallucinogen dependence with hallucinogen persisting perception disorder (flashbacks)
F16.288 Hallucinogen dependence with other hallucinogen-induced disorder
F16.29 Hallucinogen dependence with unspecified hallucinogen-induced disorder
F16.90 Hallucinogen use, unspecified, uncomplicated
F16.91 Hallucinogen use, unspecified, in remission
F16.920 Hallucinogen use, unspecified with intoxication, uncomplicated
F16.921 Hallucinogen use, unspecified with intoxication with delirium
F16.929 Hallucinogen use, unspecified with intoxication, unspecified
F16.94 Hallucinogen use, unspecified with hallucinogen-induced mood disorder
F16.950 Hallucinogen use, unspecified with hallucinogen-induced psychotic disorder with delusions
F16.951 Hallucinogen use, unspecified with hallucinogen-induced psychotic disorder with hallucinations
F16.959 Hallucinogen use, unspecified with hallucinogen-induced psychotic disorder, unspecified
F16.980 Hallucinogen use, unspecified with hallucinogen-induced anxiety disorder
F16.983 Hallucinogen use, unspecified with hallucinogen persisting perception disorder (flashbacks)
F16.988 Hallucinogen use, unspecified with other hallucinogen-induced disorder
F16.99 Hallucinogen use, unspecified with unspecified hallucinogen-induced disorder
F17.200 Nicotine dependence, unspecified, uncomplicated
F17.201 Nicotine dependence, unspecified, in remission
F17.203 Nicotine dependence unspecified, with withdrawal
F17.208 Nicotine dependence, unspecified, with other nicotine-induced disorders
F17.209 Nicotine dependence, unspecified, with unspecified nicotine-induced disorders
F17.210 Nicotine dependence, cigarettes, uncomplicated
F17.211 Nicotine dependence, cigarettes, in remission
F17.213 Nicotine dependence, cigarettes, with withdrawal
F17.218 Nicotine dependence, cigarettes, with other nicotine-induced disorders
F17.219 Nicotine dependence, cigarettes, with unspecified nicotine-induced disorders
F17.220 Nicotine dependence, chewing tobacco, uncomplicated
F17.221 Nicotine dependence, chewing tobacco, in remission
F17.223 Nicotine dependence, chewing tobacco, with withdrawal
F17.228 Nicotine dependence, chewing tobacco, with other nicotine-induced disorders
F17.229 Nicotine dependence, chewing tobacco, with unspecified nicotine-induced disorders
F17.290 Nicotine dependence, other tobacco product, uncomplicated
F17.291 Nicotine dependence, other tobacco product, in remission
F17.293 Nicotine dependence, other tobacco product, with withdrawal
F17.298 Nicotine dependence, other tobacco product, with other nicotine-induced disorders
F17.299 Nicotine dependence, other tobacco product, with unspecified nicotine-induced disorders
F18.10 Inhalant abuse, uncomplicated
F18.11 Inhalant abuse, in remission
F18.120 Inhalant abuse with intoxication, uncomplicated
F18.121 Inhalant abuse with intoxication delirium
F18.129 Inhalant abuse with intoxication, unspecified
F18.14 Inhalant abuse with inhalant-induced mood disorder
F18.150 Inhalant abuse with inhalant-induced psychotic disorder with delusions
F18.151 Inhalant abuse with inhalant-induced psychotic disorder with hallucinations
F18.159 Inhalant abuse with inhalant-induced psychotic disorder, unspecified
F18.17 Inhalant abuse with inhalant-induced dementia
F18.180 Inhalant abuse with inhalant-induced anxiety disorder
F18.188 Inhalant abuse with other inhalant-induced disorder
F18.19 Inhalant abuse with unspecified inhalant-induced disorder
F18.20 Inhalant dependence, uncomplicated
F18.21 Inhalant dependence, in remission
F18.220 Inhalant dependence with intoxication, uncomplicated
F18.221 Inhalant dependence with intoxication delirium
F18.229 Inhalant dependence with intoxication, unspecified
F18.24 Inhalant dependence with inhalant-induced mood disorder
F18.250 Inhalant dependence with inhalant-induced psychotic disorder with delusions
F18.251 Inhalant dependence with inhalant-induced psychotic disorder with hallucinations
F18.259 Inhalant dependence with inhalant-induced psychotic disorder, unspecified
F18.27 Inhalant dependence with inhalant-induced dementia
F18.280 Inhalant dependence with inhalant-induced anxiety disorder
F18.288 Inhalant dependence with other inhalant-induced disorder
F18.29 Inhalant dependence with unspecified inhalant-induced disorder
F18.90 Inhalant use, unspecified, uncomplicated
F18.91 Inhalant use, unspecified, in remission
F18.920 Inhalant use, unspecified with intoxication, uncomplicated
F18.921 Inhalant use, unspecified with intoxication with delirium
F18.929 Inhalant use, unspecified with intoxication, unspecified
F18.94 Inhalant use, unspecified with inhalant-induced mood disorder
F18.950 Inhalant use, unspecified with inhalant-induced psychotic disorder with delusions
F18.951 Inhalant use, unspecified with inhalant-induced psychotic disorder with hallucinations
F18.959 Inhalant use, unspecified with inhalant-induced psychotic disorder, unspecified
F18.97 Inhalant use, unspecified with inhalant-induced persisting dementia
F18.980 Inhalant use, unspecified with inhalant-induced anxiety disorder
F18.988 Inhalant use, unspecified with other inhalant-induced disorder
F18.99 Inhalant use, unspecified with unspecified inhalant-induced disorder
F19.10 Other psychoactive substance abuse, uncomplicated
F19.11 Other psychoactive substance abuse, in remission
F19.120 Other psychoactive substance abuse with intoxication, uncomplicated
F19.121 Other psychoactive substance abuse with intoxication delirium
F19.122 Other psychoactive substance abuse with intoxication with perceptual disturbances
F19.129 Other psychoactive substance abuse with intoxication, unspecified
F19.130 Other psychoactive substance abuse with withdrawal, uncomplicated
F19.131 Other psychoactive substance abuse with withdrawal delirium
F19.132 Other psychoactive substance abuse with withdrawal with perceptual disturbance
F19.139 Other psychoactive substance abuse with withdrawal, unspecified
F19.14 Other psychoactive substance abuse with psychoactive substance-induced mood disorder
F19.150 Other psychoactive substance abuse with psychoactive substance-induced psychotic disorder with delusions
F19.151 Other psychoactive substance abuse with psychoactive substance-induced psychotic disorder with hallucinations
F19.159 Other psychoactive substance abuse with psychoactive substance-induced psychotic disorder, unspecified
F19.16 Other psychoactive substance abuse with psychoactive substance-induced persisting amnestic disorder
F19.17 Other psychoactive substance abuse with psychoactive substance-induced persisting dementia
F19.180 Other psychoactive substance abuse with psychoactive substance-induced anxiety disorder
F19.181 Other psychoactive substance abuse with psychoactive substance-induced sexual dysfunction
F19.182 Other psychoactive substance abuse with psychoactive substance-induced sleep disorder
F19.188 Other psychoactive substance abuse with other psychoactive substance-induced disorder
F19.19 Other psychoactive substance abuse with unspecified psychoactive substance-induced disorder
F19.20 Other psychoactive substance dependence, uncomplicated
F19.21 Other psychoactive substance dependence, in remission
F19.220 Other psychoactive substance dependence with intoxication, uncomplicated
F19.221 Other psychoactive substance dependence with intoxication delirium
F19.222 Other psychoactive substance dependence with intoxication with perceptual disturbance
F19.229 Other psychoactive substance dependence with intoxication, unspecified
F19.230 Other psychoactive substance dependence with withdrawal, uncomplicated
F19.231 Other psychoactive substance dependence with withdrawal delirium
F19.232 Other psychoactive substance dependence with withdrawal with perceptual disturbance
F19.239 Other psychoactive substance dependence with withdrawal, unspecified
F19.24 Other psychoactive substance dependence with psychoactive substance-induced mood disorder
F19.250 Other psychoactive substance dependence with psychoactive substance-induced psychotic disorder with delusions
F19.251 Other psychoactive substance dependence with psychoactive substance-induced psychotic disorder with hallucinations
F19.259 Other psychoactive substance dependence with psychoactive substance-induced psychotic disorder, unspecified
F19.26 Other psychoactive substance dependence with psychoactive substance-induced persisting amnestic disorder
F19.27 Other psychoactive substance dependence with psychoactive substance-induced persisting dementia
F19.280 Other psychoactive substance dependence with psychoactive substance-induced anxiety disorder
F19.281 Other psychoactive substance dependence with psychoactive substance-induced sexual dysfunction
F19.282 Other psychoactive substance dependence with psychoactive substance-induced sleep disorder
F19.288 Other psychoactive substance dependence with other psychoactive substance-induced disorder
F19.29 Other psychoactive substance dependence with unspecified psychoactive substance-induced disorder
F19.90 Other psychoactive substance use, unspecified, uncomplicated
F19.91 Other psychoactive substance use, unspecified, in remission
F19.920 Other psychoactive substance use, unspecified with intoxication, uncomplicated
F19.921 Other psychoactive substance use, unspecified with intoxication with delirium
F19.922 Other psychoactive substance use, unspecified with intoxication with perceptual disturbance
F19.929 Other psychoactive substance use, unspecified with intoxication, unspecified
F19.930 Other psychoactive substance use, unspecified with withdrawal, uncomplicated
F19.931 Other psychoactive substance use, unspecified with withdrawal delirium
F19.932 Other psychoactive substance use, unspecified with withdrawal with perceptual disturbance
F19.939 Other psychoactive substance use, unspecified with withdrawal, unspecified
F19.94 Other psychoactive substance use, unspecified with psychoactive substance-induced mood disorder
F19.950 Other psychoactive substance use, unspecified with psychoactive substance-induced psychotic disorder with delusions
F19.951 Other psychoactive substance use, unspecified with psychoactive substance-induced psychotic disorder with hallucinations
F19.959 Other psychoactive substance use, unspecified with psychoactive substance-induced psychotic disorder, unspecified
F19.96 Other psychoactive substance use, unspecified with psychoactive substance-induced persisting amnestic disorder
F19.97 Other psychoactive substance use, unspecified with psychoactive substance-induced persisting dementia
F19.980 Other psychoactive substance use, unspecified with psychoactive substance-induced anxiety disorder
F19.981 Other psychoactive substance use, unspecified with psychoactive substance-induced sexual dysfunction
F19.982 Other psychoactive substance use, unspecified with psychoactive substance-induced sleep disorder
F19.988 Other psychoactive substance use, unspecified with other psychoactive substance-induced disorder
F19.99 Other psychoactive substance use, unspecified with unspecified psychoactive substance-induced disorder
F20.0 Paranoid schizophrenia
F20.1 Disorganized schizophrenia
F20.2 Catatonic schizophrenia
F20.3 Undifferentiated schizophrenia
F20.5 Residual schizophrenia
F20.81 Schizophreniform disorder
F20.89 Other schizophrenia
F20.9 Schizophrenia, unspecified
F21 Schizotypal disorder
F22 Delusional disorders
F23 Brief psychotic disorder
F24 Shared psychotic disorder
F25.0 Schizoaffective disorder, bipolar type
F25.1 Schizoaffective disorder, depressive type
F25.8 Other schizoaffective disorders
F25.9 Schizoaffective disorder, unspecified
F28 Other psychotic disorder not due to a substance or known physiological condition
F29 Unspecified psychosis not due to a substance or known physiological condition
F30.10 Manic episode without psychotic symptoms, unspecified
F30.11 Manic episode without psychotic symptoms, mild
F30.12 Manic episode without psychotic symptoms, moderate
F30.13 Manic episode, severe, without psychotic symptoms
F30.2 Manic episode, severe with psychotic symptoms
F30.3 Manic episode in partial remission
F30.4 Manic episode in full remission
F30.8 Other manic episodes
F30.9 Manic episode, unspecified
F31.0 Bipolar disorder, current episode hypomanic
F31.10 Bipolar disorder, current episode manic without psychotic features, unspecified
F31.11 Bipolar disorder, current episode manic without psychotic features, mild
F31.12 Bipolar disorder, current episode manic without psychotic features, moderate
F31.13 Bipolar disorder, current episode manic without psychotic features, severe
F31.2 Bipolar disorder, current episode manic severe with psychotic features
F31.30 Bipolar disorder, current episode depressed, mild or moderate severity, unspecified
F31.31 Bipolar disorder, current episode depressed, mild
F31.32 Bipolar disorder, current episode depressed, moderate
F31.4 Bipolar disorder, current episode depressed, severe, without psychotic features
F31.5 Bipolar disorder, current episode depressed, severe, with psychotic features
F31.60 Bipolar disorder, current episode mixed, unspecified
F31.61 Bipolar disorder, current episode mixed, mild
F31.62 Bipolar disorder, current episode mixed, moderate
F31.63 Bipolar disorder, current episode mixed, severe, without psychotic features
F31.64 Bipolar disorder, current episode mixed, severe, with psychotic features
F31.70 Bipolar disorder, currently in remission, most recent episode unspecified
F31.71 Bipolar disorder, in partial remission, most recent episode hypomanic
F31.72 Bipolar disorder, in full remission, most recent episode hypomanic
F31.73 Bipolar disorder, in partial remission, most recent episode manic
F31.74 Bipolar disorder, in full remission, most recent episode manic
F31.75 Bipolar disorder, in partial remission, most recent episode depressed
F31.76 Bipolar disorder, in full remission, most recent episode depressed
F31.77 Bipolar disorder, in partial remission, most recent episode mixed
F31.78 Bipolar disorder, in full remission, most recent episode mixed
F31.81 Bipolar II disorder
F31.89 Other bipolar disorder
F31.9 Bipolar disorder, unspecified
F32.0 Major depressive disorder, single episode, mild
F32.1 Major depressive disorder, single episode, moderate
F32.2 Major depressive disorder, single episode, severe without psychotic features
F32.3 Major depressive disorder, single episode, severe with psychotic features
F32.4 Major depressive disorder, single episode, in partial remission
F32.5 Major depressive disorder, single episode, in full remission
F32.81 Premenstrual dysphoric disorder
F32.89 Other specified depressive episodes
F32.9 Major depressive disorder, single episode, unspecified
F32.A Depression, unspecified
F33.0 Major depressive disorder, recurrent, mild
F33.1 Major depressive disorder, recurrent, moderate
F33.2 Major depressive disorder, recurrent severe without psychotic features
F33.3 Major depressive disorder, recurrent, severe with psychotic symptoms
F33.40 Major depressive disorder, recurrent, in remission, unspecified
F33.41 Major depressive disorder, recurrent, in partial remission
F33.42 Major depressive disorder, recurrent, in full remission
F33.8 Other recurrent depressive disorders
F33.9 Major depressive disorder, recurrent, unspecified
F34.0 Cyclothymic disorder
F34.1 Dysthymic disorder
F34.81 Disruptive mood dysregulation disorder
F34.89 Other specified persistent mood disorders
F34.9 Persistent mood [affective] disorder, unspecified
F39 Unspecified mood [affective] disorder
F40.00 Agoraphobia, unspecified
F40.01 Agoraphobia with panic disorder
F40.02 Agoraphobia without panic disorder
F40.10 Social phobia, unspecified
F40.11 Social phobia, generalized
F40.210 Arachnophobia
F40.218 Other animal type phobia
F40.220 Fear of thunderstorms
F40.228 Other natural environment type phobia
F40.230 Fear of blood
F40.231 Fear of injections and transfusions
F40.232 Fear of other medical care
F40.233 Fear of injury
F40.240 Claustrophobia
F40.241 Acrophobia
F40.242 Fear of bridges
F40.243 Fear of flying
F40.248 Other situational type phobia
F40.290 Androphobia
F40.291 Gynephobia
F40.298 Other specified phobia
F40.8 Other phobic anxiety disorders
F40.9 Phobic anxiety disorder, unspecified
F41.0 Panic disorder [episodic paroxysmal anxiety]
F41.1 Generalized anxiety disorder
F41.3 Other mixed anxiety disorders
F41.8 Other specified anxiety disorders
F41.9 Anxiety disorder, unspecified
F42.2 Mixed obsessional thoughts and acts
F42.3 Hoarding disorder
F42.4 Excoriation (skin-picking) disorder
F42.8 Other obsessive-compulsive disorder
F42.9 Obsessive-compulsive disorder, unspecified
F43.0 Acute stress reaction
F43.10 Post-traumatic stress disorder, unspecified
F43.11 Post-traumatic stress disorder, acute
F43.12 Post-traumatic stress disorder, chronic
F43.20 Adjustment disorder, unspecified
F43.21 Adjustment disorder with depressed mood
F43.22 Adjustment disorder with anxiety
F43.23 Adjustment disorder with mixed anxiety and depressed mood
F43.24 Adjustment disorder with disturbance of conduct
F43.25 Adjustment disorder with mixed disturbance of emotions and conduct
F43.29 Adjustment disorder with other symptoms
F43.81 Prolonged grief disorder
F43.89 Other reactions to severe stress
F43.9 Reaction to severe stress, unspecified
F44.0 Dissociative amnesia
F44.1 Dissociative fugue
F44.2 Dissociative stupor
F44.4 Conversion disorder with motor symptom or deficit
F44.5 Conversion disorder with seizures or convulsions
F44.6 Conversion disorder with sensory symptom or deficit
F44.7 Conversion disorder with mixed symptom presentation
F44.81 Dissociative identity disorder
F44.89 Other dissociative and conversion disorders
F44.9 Dissociative and conversion disorder, unspecified
F45.0 Somatization disorder
F45.1 Undifferentiated somatoform disorder
F45.20 Hypochondriacal disorder, unspecified
F45.21 Hypochondriasis
F45.22 Body dysmorphic disorder
F45.29 Other hypochondriacal disorders
F45.41 Pain disorder exclusively related to psychological factors
F45.42 Pain disorder with related psychological factors
F45.8 Other somatoform disorders
F45.9 Somatoform disorder, unspecified
F48.1 Depersonalization-derealization syndrome
F48.2 Pseudobulbar affect
F48.8 Other specified nonpsychotic mental disorders
F48.9 Nonpsychotic mental disorder, unspecified
F50.00 Anorexia nervosa, unspecified
F50.010 Anorexia nervosa, restricting type, mild
F50.011 Anorexia nervosa, restricting type, moderate
F50.012 Anorexia nervosa, restricting type, severe
F50.013 Anorexia nervosa, restricting type, extreme
F50.014 Anorexia nervosa, restricting type, in remission
F50.019 Anorexia nervosa, restricting type, unspecified
F50.020 Anorexia nervosa, binge eating/purging type, mild
F50.021 Anorexia nervosa, binge eating/purging type, moderate
F50.022 Anorexia nervosa, binge eating/purging type, severe
F50.023 Anorexia nervosa, binge eating/purging type, extreme
F50.024 Anorexia nervosa, binge eating/purging type, in remission
F50.029 Anorexia nervosa, binge eating/purging type, unspecified
F50.20 Bulimia nervosa, unspecified
F50.21 Bulimia nervosa, mild
F50.22 Bulimia nervosa, moderate
F50.23 Bulimia nervosa, severe
F50.24 Bulimia nervosa, extreme
F50.25 Bulimia nervosa, in remission
F50.810 Binge eating disorder, mild
F50.811 Binge eating disorder, moderate
F50.812 Binge eating disorder, severe
F50.813 Binge eating disorder, extreme
F50.814 Binge eating disorder, in remission
F50.819 Binge eating disorder, unspecified
F50.82 Avoidant/restrictive food intake disorder
F50.89 Other specified eating disorder
F50.9 Eating disorder, unspecified
F51.01 Primary insomnia
F51.02 Adjustment insomnia
F51.03 Paradoxical insomnia
F51.09 Other insomnia not due to a substance or known physiological condition
F51.11 Primary hypersomnia
F51.12 Insufficient sleep syndrome
F51.19 Other hypersomnia not due to a substance or known physiological condition
F51.3 Sleepwalking [somnambulism]
F51.4 Sleep terrors [night terrors]
F51.5 Nightmare disorder
F51.8 Other sleep disorders not due to a substance or known physiological condition
F51.9 Sleep disorder not due to a substance or known physiological condition, unspecified
F52.0 Hypoactive sexual desire disorder
F52.1 Sexual aversion disorder
F52.21 Male erectile disorder
F52.22 Female sexual arousal disorder
F52.31 Female orgasmic disorder
F52.32 Male orgasmic disorder
F52.4 Premature ejaculation
F52.5 Vaginismus not due to a substance or known physiological condition
F52.6 Dyspareunia not due to a substance or known physiological condition
F52.8 Other sexual dysfunction not due to a substance or known physiological condition
F52.9 Unspecified sexual dysfunction not due to a substance or known physiological condition
F54 Psychological and behavioral factors associated with disorders or diseases classified elsewhere
F55.0 Abuse of antacids
F55.1 Abuse of herbal or folk remedies
F55.2 Abuse of laxatives
F55.3 Abuse of steroids or hormones
F55.4 Abuse of vitamins
F55.8 Abuse of other non-psychoactive substances
F59 Unspecified behavioral syndromes associated with physiological disturbances and physical factors
F60.0 Paranoid personality disorder
F60.1 Schizoid personality disorder
F60.2 Antisocial personality disorder
F60.3 Borderline personality disorder
F60.4 Histrionic personality disorder
F60.5 Obsessive-compulsive personality disorder
F60.6 Avoidant personality disorder
F60.7 Dependent personality disorder
F60.81 Narcissistic personality disorder
F60.89 Other specific personality disorders
F60.9 Personality disorder, unspecified
F63.0 Pathological gambling
F63.1 Pyromania
F63.2 Kleptomania
F63.3 Trichotillomania
F63.81 Intermittent explosive disorder
F63.89 Other impulse disorders
F63.9 Impulse disorder, unspecified
F64.0 Transsexualism
F64.1 Dual role transvestism
F64.2 Gender identity disorder of childhood
F64.8 Other gender identity disorders
F64.9 Gender identity disorder, unspecified
F65.0 Fetishism
F65.1 Transvestic fetishism
F65.2 Exhibitionism
F65.3 Voyeurism
F65.4 Pedophilia
F65.50 Sadomasochism, unspecified
F65.51 Sexual masochism
F65.52 Sexual sadism
F65.81 Frotteurism
F65.89 Other paraphilias
F65.9 Paraphilia, unspecified
F66 Other sexual disorders
F68.10 Factitious disorder imposed on self, unspecified
F68.11 Factitious disorder imposed on self, with predominantly psychological signs and symptoms
F68.12 Factitious disorder imposed on self, with predominantly physical signs and symptoms
F68.13 Factitious disorder imposed on self, with combined psychological and physical signs and symptoms
F68.8 Other specified disorders of adult personality and behavior
F69 Unspecified disorder of adult personality and behavior
F70 Mild intellectual disabilities
F71 Moderate intellectual disabilities
F72 Severe intellectual disabilities
F73 Profound intellectual disabilities
F78.A1 SYNGAP1-related intellectual disability
F78.A9 Other genetic related intellectual disability
F79 Unspecified intellectual disabilities
F80.0 Phonological disorder
F80.1 Expressive language disorder
F80.2 Mixed receptive-expressive language disorder
F80.4 Speech and language development delay due to hearing loss
F80.81 Childhood onset fluency disorder
F80.82 Social pragmatic communication disorder
F80.89 Other developmental disorders of speech and language
F80.9 Developmental disorder of speech and language, unspecified
F81.0 Specific reading disorder
F81.2 Mathematics disorder
F81.81 Disorder of written expression
F81.89 Other developmental disorders of scholastic skills
F81.9 Developmental disorder of scholastic skills, unspecified
F82 Specific developmental disorder of motor function
F84.0 Autistic disorder
F84.3 Other childhood disintegrative disorder
F84.5 Asperger's syndrome
F84.8 Other pervasive developmental disorders
F84.9 Pervasive developmental disorder, unspecified
F88 Other disorders of psychological development
F89 Unspecified disorder of psychological development
F90.0 Attention-deficit hyperactivity disorder, predominantly inattentive type
F90.1 Attention-deficit hyperactivity disorder, predominantly hyperactive type
F90.2 Attention-deficit hyperactivity disorder, combined type
F90.8 Attention-deficit hyperactivity disorder, other type
F90.9 Attention-deficit hyperactivity disorder, unspecified type
F91.0 Conduct disorder confined to family context
F91.1 Conduct disorder, childhood-onset type
F91.2 Conduct disorder, adolescent-onset type
F91.3 Oppositional defiant disorder
F91.8 Other conduct disorders
F91.9 Conduct disorder, unspecified
F93.0 Separation anxiety disorder of childhood
F93.8 Other childhood emotional disorders
F93.9 Childhood emotional disorder, unspecified
F94.0 Selective mutism
F94.1 Reactive attachment disorder of childhood
F94.2 Disinhibited attachment disorder of childhood
F94.8 Other childhood disorders of social functioning
F94.9 Childhood disorder of social functioning, unspecified
F95.0 Transient tic disorder
F95.1 Chronic motor or vocal tic disorder
F95.2 Tourette's disorder
F95.8 Other tic disorders
F95.9 Tic disorder, unspecified
F98.0 Enuresis not due to a substance or known physiological condition
F98.1 Encopresis not due to a substance or known physiological condition
F98.21 Rumination disorder of infancy and childhood
F98.29 Other feeding disorders of infancy and early childhood
F98.3 Pica of infancy and childhood
F98.4 Stereotyped movement disorders
F98.5 Adult onset fluency disorder
F98.8 Other specified behavioral and emotional disorders with onset usually occurring in childhood and adolescence
F98.9 Unspecified behavioral and emotional disorders with onset usually occurring in childhood and adolescence
F99 Mental disorder, not otherwise specified
G30.0 Alzheimer's disease with early onset
G30.1 Alzheimer's disease with late onset
G30.8 Other Alzheimer's disease
G30.9 Alzheimer's disease, unspecified
G31.01 Pick's disease
G31.09 Other frontotemporal neurocognitive disorder
G31.1 Senile degeneration of brain, not elsewhere classified
G31.83 Neurocognitive disorder with Lewy bodies
G31.84 Mild cognitive impairment of uncertain or unknown etiology
G31.85 Corticobasal degeneration
G44.209 Tension-type headache, unspecified, not intractable
H93.25 Central auditory processing disorder
R37 Sexual dysfunction, unspecified
R45.1 Restlessness and agitation
R45.2 Unhappiness
R45.5 Hostility
R45.6 Violent behavior
R45.7 State of emotional shock and stress, unspecified
R45.81 Low self-esteem
R45.82 Worries
R45.88 Nonsuicidal self-harm
R48.0 Dyslexia and alexia
T14.91XA Suicide attempt, initial encounter
T14.91XD Suicide attempt, subsequent encounter
T14.91XS Suicide attempt, sequela
Z87.890 Personal history of sex reassignment
Z91.51 Personal history of suicidal behavior
Z91.52 Personal history of nonsuicidal self-harm
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ICD-10-PCS Codes

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 Group 1 Codes

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Additional ICD-10 Information

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Bill Type Codes

Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type. Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the article should be assumed to apply equally to all claims.

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Revenue Codes

Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination. Complete absence of all Revenue Codes indicates that coverage is not influenced by Revenue Code and the article should be assumed to apply equally to all Revenue Codes.

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Coding Table Information

Excluded CPT/HCPCS Codes - Table Format
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Non-Excluded CPT/HCPCS Ended Codes - Table Format
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Revision History Information

Revision History Date Revision History Number Revision History Explanation
10/01/2024 R10

Due to the annual ICD-10 code update, F50.01, F50.02, F50.2 and F50.81 have been deleted from Group 1 in the ICD-10-CM Codes that DO NOT Support Medical Necessity section, and the following codes have been added: F50.010, F50.011, F50.012, F50.013, F50.014, F50.019, F50.020, F50.021, F50.022, F50.023, F50.024, F50.029, F50.20, F50.21, F50.22, F50.23, F50.24, F50.25, F50.810, F50.811, F50.812, F50.813, F50.814, F50.819.

Effective 01/01/2024, Under the article text, coding information, the referenced CPT code range 90801-90899 has been revised to remove deleted codes 90801 and 90802, and to add CPT codes 90791 and 90792.
01/01/2024 R9

Due to CR 13469, the article text was updated to add "Health Behavior Assessment and Intervention (HBAI) services described by CPT codes 96156, 96158, 96159, 96164, 96165, 96167, and 96168, and any successor codes, are billed by clinical social workers, marriage and family therapists (MFTs), and mental health counselors (MHCs), in addition to clinical psychologists." Coding references have been updated. 
10/01/2022 R8

Due to the annual ICD-10 updates for 2023, ICD-10 code descriptions were changed: F01.50, F02.80, F03.90, G31.09, G31.83, G31.84.
The following ICD-10 codes were deleted from the ICD-10 Codes that DO NOT Support Medical Necessity, Group 1: F01.51, F02.81, F03.91, F43.8.
The following ICD-10 codes were added to the ICD-10 Codes that DO NOT Support Medical Necessity, Group 1: F01.511, F01.518, F01.52, F01.53, F01.54, F01.A0, F01.A11, F01.A18, F01.A2, F01.A3, F01.A4, F01.B0, F01.B11, F01.B18, F01.B2, F01.B3, F01.B4, F01.C0, F01.C11, F01.C18, F01.C2, F01.C3, F01.C4, F02.811, F02.818, F02.82, F02.83, F02.84, F02.A0, F02.A11, F02.A18, F02.A2, F02.A3, F02.A4, F02.B0, F02.B11, F02.B18, F02.B2, F02.B3, F02.B4, F02.C0, F02.C11, F02.C18, F02.C2, F02.C3, F02.C4, F03.911, F03.918, F03.92, F03.93, F03.94, F03.A0, F03.A11, F03.A18, F03.A2, F03.A3, F03.A4, F03.B0, F03.B11, F03.B18, F03.B2, F03.B3, F03.B4, F03.C0, F03.C11, F03.C18, F03.C2, F03.C3, F03.C4, F06.70, F06.71, F10.90, F10.91, F11.91, F12.91, F13.91, F14.91, F15.91, F16.91, F18.91, F19.91, F43.81, F43.89.
10/01/2021 R7

Based on the annual ICD-10 updates for 2022, the following code was deleted from ICD-10 Codes that DO NOT Support Medical Necessity, Group 1: F78. The following codes were added to ICD-10 Codes that DO NOT Support Medical Necessity, Group 1: F32.A, F78.A1, F78.A9, R45.88, Z91.51,and Z91.52.
10/01/2020 R6

Based on the annual ICD-10 updates for 2021, the following codes were added to ICD-10 Codes that DO NOT Support Medical Necessity, Group 1: F10.130, F10.131, F10.132, F10.139, F10.930, F10.931, F10.932, F10.939, F11.13, F12.13, F13.130, F13.131, F13.132, F13.139, F14.13, F14.93, F15.13, F19.130, F19.131, F19.132, and F19.139.
01/01/2020 R5

Due to annual CPT/HCPCS updates, CPT codes 96150, 96151, 96152, 96153, 96154, and 96155 have been deleted from the "CPT/HCPCS Codes" section Group 1 and the following new codes were added: 96156, 96158, 96159, 96164, 96165, 96167, 96168, 96170, and 96171.

Bill types and Revenue codes have been removed from this article.

10/01/2018 R4

Due to the annual ICD-10-CM update the following ICD-10 code descriptions were changed in the "Non-Covered ICD-10 Codes" section- Group 1: F68.10, F68.11, F68.12, F68.13.

The following ICD-10 code was deleted from the "Non-Covered ICD-10 Codes" section- Group 1: F53.

The following ICD-10 codes were added to "Non-Covered ICD-10 Codes" section- Group 1: F12.23, F12.93.

10/01/2018: At this time 21st Century Cures Act will apply to new and revised LCDs that restrict coverage which requires comment and notice. This revision is not a restriction to the coverage determination; and, therefore not all the fields included on the LCD are applicable as noted in this policy.
10/01/2017 R3

Due to the annual ICD-10-CM update, the following ICD-10 codes were added to the ICD-10 Codes that Do Not Support Medical Necessity section: F10.11, F11.11, F12.11, F13.11, F14.11, F15.11, F16.11, F18.11, F19.11, F50.82, T14.91XA, T14.91XD, and T14.91XS.

Due to the annual ICD-10-CM update, the following ICD-10 code F41.0 description was changed from “Panic disorder [episodic paroxysmal anxiety] without agoraphobia” to “Panic disorder [episodic paroxysmal anxiety]” in the Non-Covered ICD-10 Codes section.

DATE (10/01/2017): At this time 21st Century Cures Act will apply to new and revised LCDs that restrict coverage which requires comment and notice. This revision is not a restriction to the coverage determination; and, therefore not all the fields included on the LCD are applicable as noted in this policy.

 
10/01/2016 R2 Added multiple ICD-10-CM codes to the Non-Covered ICD-10 Code section, due to the annual ICD-10-CM update.
10/01/2015 R1 Place of service guidelines for Part B have been removed from the article, and other template changes have been made.
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Medicare BPM Ch 15.50.2 SAD Determinations
Medicare BPM Ch 15.50.2
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