Cocaine 292.9 F14.159 F14.259 F14.959
Other (or unknown) substance 292.9 F19.159 F19.259 F19.959
Specify it (see Table 1 in the chapter “Substance-Related and Addictive Disorders” for diag- noses associated with substance class):
With onset during intoxication: It the criteria are met for intoxication with the sub- stance and the symptoms develop during intoxication.
With onset during withdrawal: If the criteria are met for withdrawal from the sub- stance and the symptoms develop during, or shortly after, withdrawal.
Specify current severity:
Severity is rated by a quantitative assessment of the primary symptoms of psychosis, including delusions, hallucinations, abnormal psychomotor behavior. and negative symptoms. Each of these symptoms may be rated for its current severity (most severe in the last 7 days) on a 5-point scale ranging from 0 (not present) to 4 (present and severe). (See CIinician-Rated Dimensions of Psychosis Symptom Severity in the chap-
Note: Diagnosis of substance/medication-induced psychotic disorder can be made without using this severity specifier.
lCD-9-CM. The name of the substance/medication-induced psychotic disorder begins with the specific substance (e.g., cocaine, dexamethasone) that is presumed to be causing the delusions or hallucinations. 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 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 sub- stance is unknown, the category "unknown substance” should be used.
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 delusions occurring during intoxication in a man with a severe co- caine use disorder, the diagnosis is 292.9 cocaine-induced psychotic 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 psychotic symptoms, each should be listed separately (e.g., 292.9 cannabis-induced psy- chotic disorder with onset during intoxication, with severe cannabis use disorder; 292.9 phencyclidine-induced psychotic disorder, with onset during intoxication, with mild phencyclidine use disorder).
|CD-10-CM. The name of the substance/medicati0n-induced psychotic disorder begins with the specific substance (e.g., cocaine, dexamethasone) that is presumed to be causing the delusions or hallucinations. The diagnostic code is selected from the table included in the criteria set, which is based on the drug class and presence or absence of a comorbid substance use disorder. For substances that do not fit into any of the classes (e.g., dexa- methasone), the code for ”other substance" with no comorbid substance use 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” with no comorbid sub- stance use should be used.