Witii onset during withd rawai: If criteria are met for withdrawal from the substance and the symptoms develop during, or shorﬂy after, withdrawal.
Witli onset after medication use: Symptoms may appear either at initiation of medi- cation or after a modification or change in use.
ICD-9-CM. The name of the substance/ medication—induced obsessive—compulsive and related disorderbegins With the specific substance (e.g., cocaine) that is presumed to be causing the obsessive—compulsive and related symptoms. The diagnostic code is selected from the table included in the criteria set, Which is based on the drug class. For substances that do not fit into any ofthe classes, the code for "other sub stance" should be used; and in cases in Which a substance isjudged to be an etiological factor but the specific class ofsub stance is unknown, the category "unknown substance" should be used.
The name ofthe disord er is follow ed by the specification ofonset (i.e., onset during in toxication, onset during Withdraw a1, With onset after med ication use). Unlike the record ing procedures for ICD—IO—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 ofrepetitive behaviors oc curring during intoxication in a man With a severe cocaine use disorder, the diagno sis is 292.89 cocaine—induced obsessive—compulsive and related disorder, With onset during in toxication. An additional diagnosis of 304.20 severe cocaine use disorder is also given.
When more than one substance is jud ged to play a significant role in the development of the obsessive—compulsive and related disorder, each should be listed separately.
|CD-10-CM. The name ofthe substance/ medication—induced obsessive—compulsive and re lated disorder begins With the specific substance (e.g., cocaine) that is presumed to be causing the obsessive—compulsive and related symptoms. The diagnostic code is selected from the ta ble included in the criteria set, Which is based on the drug class and presence or absence ofa comorbid substance use disorder. For substances that do not fit into any of the classes, the code for "other substance" With no comorbid substance use should be used; and in cases in
Which a sub stance isjudged to be an etiological factorbut the specific class ofsub stance is un known, the category "unknown substance" With no comorbid substance use 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 ob- sessive-compulsive and related disorder, followed by the specification of onset (i.e., onset dur- ing intoxication, onset during withdrawal, with onset after medication use). For example, in the case of repetitive behaviors occurring during intoxication in a man with a severe cocaine use disorder, the diagnosis is F14.288 severe cocaine use disorder with cocaine-induced obses- sive—compulsive and related disorder, with onset during intoxication. A separate diagnosis of the comorbid severe cocaine use disorder is not given. If the substance-induced obsessive- compulsive 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.,
F15.988 amphetamine—induced obsessive—compulsive and related disorder, with onset during intoxication). When more than one substance is judged to play a significant role in the devel- opment of the obsessive—compulsive and related disorder, each should be listed separately.