Coding based on current severity: Note for ICD-10-CM codes: If a phencyclidine intoxica- tion or another phencyclidine-induced mental disorder is also present, do not use the codes below for phencyclidine use disorder. Instead, the comorbid phencyclidine use disorder is in- dicated in the 4th character of the phencyclidine-induced disorder code (see the coding note for phencyclidine intoxication or a specific phencyclidine-induced mental disorder). For ex- ample, it there is comorbid phencyclidine-induced psychotic disorder, only the phencyclidine- induced psychotic disorder code is given, with the 4th character indicating whether the co- morbid phencyclidine use disorder is mild, moderate, or severe: F16.159 for mild phencycli- dine use disorder with phencyclidine-induced psychotic disorder or F16.259 for a moderate or severe phencyclidine use disorder with phencyclidine-induced psychotic disorder.
Specify current severity: 305.90 (F16.10) Mild: Presence of 2—3 symptoms.
304.60 (F16.20) Moderate: Presence of 4—5 symptoms.
304.60 (F16.20) Severe: Presence of 6 or more symptoms.
"In a controlled environment" applies as a further specifier of remission if the individual is both in remission and in a controlled environment (i.e., in early remission in a controlled environment or in sustained remission in a controlled environment). Examples of these environments are closely supervised and substance-free jails, therapeutic communities, and locked hospital units.
The phencyclidines (or phencyclidine-like substances) include phencyclidine (e.g., PCP, ”angel dust”) and less potent but similarly acting compounds such as ketamine, cyclohex- amine, and dizocilpine. These substances were first developed as dissociative anesthetics in the 19505 and became street drugs in the 19605. They produce feelings of separation from mind and body (hence ”dissociative”) in low doses, and at high doses, stupor and coma can result. These substances are most commonly smoked or taken orally, but they may also be snorted or injected. Although the primary psychoactive effects of PCP last for a few hours, the total elimination rate of this drug from the body typically extends 8 days or longer. The hallucinogenic effects in vulnerable individuals may last for weeks and may precipitate a persistent psychotic episode resembling schizophrenia. Ketamine has been observed to have utility in the treatment of major depressive disorder. Withdrawal symp- toms have not been clearly established in humans, and therefore the withdrawal criterion is not included in the diagnosis of phencyclidine use disorder.
Phencyclidine may be detected in urine for up to 8 days or even longer at very high doses. In addition to laboratory tests to detect its presence, characteristic symptoms resulting from intoxication with phencyclidine or related substances may aid in its diagnosis. Phencycli- dine is likely to produce dissociative symptoms, analgesia, nystagmus, and hypertension, with risk of hypotension and shock. Violent behavior can also occur with phencyclidine use, as intoxicated persons may believe that they are being attacked. Residual symptoms following use may resemble schizophrenia.