The name of the disorder is followed by the specification of onset (i.e., onset during in- toxication, onset during withdrawal). Unlike the recording procedures for ICD-lO-CM, which combine the substance-induced disorder and substance use disorder into a single code, for ICD-9-CM a separate diagnostic code is given for the substance use disorder. For example, in the case of irritable symptoms occurring during intoxication in a man with a severe cocaine use disorder, the diagnosis is 292.84 cocaine-induced bipolar and related disorder, with onset during intoxication. An additional diagnosis of 304.20 severe cocaine use disorder is also given. When more than one substance is judged to play a significant role in the development of bipolar mood symptoms, each should be listed separately (e.g., 292.84 methylphenidate-induced bipolar and related disorder, with onset during intoxi- cation; 292.84 dexamethasone-induced bipolar and related disorder, with onset during in- toxication).
|CD-10-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 and presence or absence of a co- morbid substance use disorder. 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 un- known, the category "unknown substance” should be used.
When recording the name of the disorder, the comorbid substance use disorder (if any) is listed first, followed by the word ”with," followed by the name of the substance-induced bipolar and related disorder, followed by the specification of onset (i.e., onset during in— toxication, onset during withdrawal). For example, in the case of irritable symptoms oc- curring during intoxication in a man with a severe cocaine use disorder, the diagnosis is
F1424 severe cocaine use disorder with cocaine-induced bipolar and related disorder, with onset during intoxication. A separate diagnosis of the comorbid severe cocaine use disorder is not given. If the substance—induced bipolar and related disorder occurs without a comorbid substance use disorder (e.g., after a one-time heavy use of the substance), no accompanying substance use disorder is noted (e.g., F1594 amphetamine-induced bipolar and related disorder, with onset during intoxication). When more than one substance is judged to play a significant role in the development of bipolar mood symptoms, each should be listed separately (e.g., F15.24 severe methylphenidate use disorder with meth- ylphenidate-induced bipolar and related disorder, with onset during intoxication; F1994 dexamethasone-induced bipolar and related disorder, with onset during intoxication).