ICD-10 F16
Non-Billable HeaderHallucinogen related disorders
About ICD-10-CM F16
ICD-10-CM code F16 represents Hallucinogen related disorders. This is a non-billable header code in the Mental, Behavioral, and Neurodevelopmental chapter (block F16). The 2026 edition of ICD-10-CM F16 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.
Includes
- ecstasy
- PCP
- phencyclidine
Medicare LCD Coverage for F16
Local Coverage Determinations (LCDs) from CMS MACs that list F16 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing F16.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but F16 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with F16
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Codes Adjacent To F16
Other codes in section F10-F19 (Mental and behavioral disorders due to psychoactive substance use).
ICD-10 F16, Billing FAQ
Is ICD-10 code F16 billable? +
No, F16 is a non-billable header code. Use a more specific child code from block F16 when submitting claims.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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