D. The disturbance does not occur exclusively during the course of a delirium.
E. The disturbance causes clinically significant distress or impairment in social, occupa- tional, or other important areas of functioning.
Coding note: The ICD-Q-CM and ICD-10-CM codes for the [specific substance/medication]- induced bipolar and related disorders are indicated in the table below. Note that the ICD-10-
CM code depends on whether or not there is a comorbid substance use disorder present for the same class of substance. If a mild substance use disorder is comorbid with the substance- induced bipolar and related disorder, the 4th position character is “1," and the clinician should record “mild [substance] use disorder’ before the substance-induced bipolar and related dis- order (e.g., “mild cocaine use disorder with cocaine-induced bipolar and related disordef'). If a moderate or severe substance use disorder is comorbid with the substance-induced bipolar and related disorder, the 4th position character is “2," and the clinician should record “moder- ate [substance] use disorder" or “severe [substance] use disorder," depending on the severity of the comorbid substance use disorder. If there is no comorbid substance use disorder (e.g., after a one-time heavy use of the substance), then the 4th position character is ”9," and the clinician should record only the substance-induced bipolar and related disorder.
With use disorder, Without disorder, moderate use
Alcohol 291.89 F1014 F1024 F10.94
Phencyclidine 292.84 F1614 F1624 F1694
Other hallucinogen 292.84 F1614 F1624 F1694
With use disorder, Without disorder, moderate use
Sedative, hypnotic, or anxiolytic 292.84 F1314 F1324 F1394
Amphetamine (or other 292.84 F1514 F1524 F1594
Cocaine 292.84 F14.14 F1424 F1494
Other (or unknown) substance 292.84 F1914 F1924 F1994
Specify if (see Table 1 in the chapter “Substance-Ftelated and Addictive Disorders" for di- agnoses associated with substance class):
With onset during intoxication: If the criteria are met for intoxication with the sub- stance and the symptoms develop during intoxication.
With onset during withdrawal: If criteria are met for withdrawal from the substance and the symptoms develop during, or shortly after, withdrawal.
|CD-9-CM. The name of the substance/medication-induced bipolar and related disor- der begins with the specific substance (e.g., cocaine, dexamethasone) that is presumed to be causing the bipolar mood symptoms. The diagnostic code is selected from the table in- cluded in the criteria set, which is based on the drug class. For substances that do not fit into any of the classes (e.g., dexamethasone), the code for ”other substance” should be used; and in cases in which a substance is judged to be an etiological factor but the specific class of substance is unknown, the category ”unknown substance” should be used.