Is ICD-10-CM code F16 billable?

No, F16 (Hallucinogen related disorders) is a non-billable ICD-10-CM code. It must be coded to a more specific subcategory before it can be used for reimbursement.

What chapter does ICD-10-CM code F16 belong to?

F16 belongs to Chapter 5 of the ICD-10-CM tabular list: F01–F99 (Mental, Behavioral and Neurodevelopmental Disorders).

F16Not billable, use a more specific code below

Hallucinogen related disorders

In Mental and behavioral disorders due to psychoactive substance use (F10-F19), chapter 5: Mental, Behavioral and Neurodevelopmental Disorders

40 billable codes under F16: 14 are a CC; 38 map to HCC 137 (Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications), HCC 135 (Drug Use with Psychotic Complications), HCC 138 (Drug Use Disorder, Mild, Uncomplicated, Except Cannabis).A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment. An HCC counts toward a Medicare Advantage patient's risk score.

Instructional notes

Includes: conditions that are coded here

ecstasy
PCP
phencyclidine

Official coding guidelines

From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.

Section I.C.5.b Mental and behavioral disorders due to psychoactive substance use (page 43), covers F16
Code only one pattern per substance: dependence outranks abuse and use, and abuse outranks use. Remission and unspecified use codes need provider documentation; code medical conditions separately with the substance code.

All codes under F16

F16 can't be used on a claim. Pick a billable code below; grey headings group them.

F16 MS-DRGs

As the principal diagnosis, all 40 billable codes under F16 group to MS-DRG 894, 895, 896, or 897 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

Other codes that refer to F16

Notes on these codes point to F16.

O99.32 Use Additional Code: code(s) from F11-F16 and F18-F19 to identify manifestations of the drug use
Z71.5 Use Additional Code: code for drug abuse or dependence (F11-F16, F18-F19)
Z81.3 Includes: Conditions classifiable to F11-F16, F18-F19

About the condition

Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.

Drug Use and Addiction

Drugs are chemical substances that can change how your body and mind work. They include prescription medicines, over-the-counter medicines, alcohol, tobacco, and illegal drugs.

Code history

Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.