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F19.95 ICD-10-CM Code: Other psychoactive substance use, unspecified with psychoactive substance-induced psychotic disorder

Billing Status: NO. This is a clinician non-billable / parent hierarchy grouping in the ICD-10-CM system.

Coding at a Glance

Tabular directives
1 inclusion term · 2 Excludes1

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for F19.95 in the official ICD-10-CM tabular list, quoted as published.

Notes without a marker are published on F19.95 itself; “inherited from” names the category or block whose note applies here.

Includes

Conditions the official ICD-10-CM tabular list includes under this code.

  • polysubstance drug use (indiscriminate drug use)

Source: inherited from F19

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Source: inherited from F19.9

Coder workflow for F19.95

MedCoder structured workflow — derived from this code’s own official record

Before you code F19.95

  1. F19.95 is not reportable as written. Select the more specific code beneath it that the documentation supports. Codes are reported to the highest level of specificity the classification provides (Guidelines I.B.2).

    ReviewF19.950, F19.951, F19.959

    See the relationships section · Guide: How to choose an ICD-10-CM code →

  2. Unspecified does not mean incorrect. When the record gives no greater specificity, F19.95 may be the appropriate code. Check the record for detail that supports a more specific sibling — in this subcategory the siblings differ by the presence or absence of the associated condition. An unspecified code is for records that do not provide the detail a more specific code needs; a query, not an assumption, is the route to specificity (Guidelines I.A.9.b, I.B.18).

    See the relationships section · Guide: Other vs unspecified (NEC vs NOS) →

  3. F19.95’s title joins a condition with an associated condition or complication. Confirm each component is documented. Where the classification presumes the link through the “with” convention, only a provider statement that the conditions are unrelated defeats it. A combination code is assigned only when it fully identifies the documented conditions; a required second code for the stage, type or manifestation is still reported when the notes ask for it (Guidelines I.B.9, I.A.15).

    Guide: Combination codes →

  4. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with F19.95. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

    See the official tabular notes

Choose the right path

  1. Does the documentation support one of the more specific codes beneath F19.95?
    Yes → Select that code and continue the checks below on its own page.
    No → F19.95 cannot be reported as written; query for the specificity its subcategory needs.

    ReviewF19.950, F19.951, F19.959

  2. Does the record document the detail a more specific sibling code needs?
    Yes → Review the specific siblings in this subcategory.
    No → Continue — F19.95 is appropriate when the documentation goes no further.
  3. Does the documentation support a condition named in F19.95’s Excludes1 note?
    Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
    No → Continue.

    ReviewF19.1, F19.2

Consider F19.95. Then confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
The associated condition or complication
Whether the associated condition the title names is documented; the “with” convention presumes some links, and a provider statement that the conditions are unrelated defeats it (Guidelines I.A.15).
Any detail beyond this code’s title
What the record states that a more specific sibling code would capture — or its absence, which itself supports the unspecified code.

Official instructions as workflow

  • Excludes1 — check before selecting F19.95(2 notes)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with F19.95: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareF19.1, F19.2

    See the official tabular notes · Guidelines I.A.12.a

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: The provider documents the condition in the terms of this code’s title and records no further detail.

Coding question: Is a more specific sibling code supportable?

Path: Review the subcategory for a sibling that names the missing detail.

Reason: A more specific code needs documentation of the distinguishing element; without it the unspecified code is appropriate, and a provider query is the route to specificity (Guidelines I.A.9.b, I.B.18).

Documentation: Both the condition F19.95 describes and a condition named in its Excludes1 note are documented for the same encounter.

Coding question: Can both codes be reported?

Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.

Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).

ReviewF19.1, F19.2

Documentation: Only one of the components this code’s title joins is documented.

Coding question: Is F19.95 supported?

Path: Review the code for the documented component on its own.

Reason: A combination code is assigned only when it fully identifies the documented conditions; otherwise the documented component takes its own code (Guidelines I.B.9).

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Code Overview

Other psychoactive substance use, unspecified with psychoactive substance-induced psychotic disorder is a non-billable ICD-10-CM category code (F19.95). A more specific billable subcode must be selected for claims submission.

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Verify Before Coding

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

Other codes that name F19.95 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 4 Excludes1 notes across 2 chapters: F19.1 — Other psychoactive substance abuse (via F19.9.-), F19.2 — Other psychoactive substance dependence (via F19.9.-), R41.3 — Other amnesia (via F19.-), R44 — Other symptoms and signs involving general sensations and perceptions (via F19.-).

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

Referenced by 33 Excludes2 notes across 4 chapters: F02 — Dementia in other diseases classified elsewhere (via F19.-), F06 — Other mental disorders due to known physiological condition (via F19.-), F06.0 — Psychotic disorder with hallucinations due to known physiological condition (via F19.-), F06.2 — Psychotic disorder with delusions due to known physiological condition (via F19.-), F06.3 — Mood disorder due to known physiological condition (via F19.-), F06.4 — Anxiety disorder due to known physiological condition (via F19.-), F20 — Schizophrenia (via F19.-), F55 — Abuse of non-psychoactive substances (via F19.-), F63 — Impulse disorders (via F19.-), F63.1 — Pyromania (via F19.-), R78 — Findings of drugs and other substances, not normally found in blood (via F19.-), T36 — Poisoning by, adverse effect of and underdosing of systemic antibiotics (via F19.-), T36-T39 — Antibiotics & Anti-infectives (T36-T39) (via F19.-), T36-T50 — Poisoning by, adverse effects of and underdosing of drugs, medicaments and biological substances (T36-T50) (via F19.-), T37 — Poisoning by, adverse effect of and underdosing of other systemic anti-infectives and antiparasitics (via F19.-), T38 — Poisoning by, adverse effect of and underdosing of hormones and their synthetic substitutes and antagonists, not elsewhere classified (via F19.-), T39 — Poisoning by, adverse effect of and underdosing of nonopioid analgesics, antipyretics and antirheumatics (via F19.-), T40 — Poisoning by, adverse effect of and underdosing of narcotics and psychodysleptics [hallucinogens] (via F19.-), T40-T41 — Analgesics & Antipyretics (T40-T41) (via F19.-), T41 — Poisoning by, adverse effect of and underdosing of anesthetics and therapeutic gases (via F19.-), +13 more.

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

Referenced by 2 Use Additional Code instructions across 2 chapters: O99.32 — Drug use complicating pregnancy, childbirth, and the puerperium (via F19.-), Z71.5 — Drug abuse counseling and surveillance (via F19.-).

These codes instruct coders to additionally report this code when it applies.

Contextual Map

Every relationship of F19.95 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run F19.95 with these 14 related codes in Claim Check

Hierarchy

Referenced by Excludes1 notes

Referenced by Excludes2 notes (33)

Referenced by Use Additional Code instructions

Nearest codes (40)

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Common coding questions

Can F19.95 be billed directly?

No. F19.95 (Other psychoactive substance use, unspecified with psychoactive substance-induced psychotic disorder) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder structured relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Other psychoactive substance use, unspecified with psychoactive substance-induced psychotic disorder

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027 (effective October 1, 2026), and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to F19.95 in its code family, with their registry titles.

View all codes in the F19 family