ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 F16.90

Billable / Specific

Hallucinogen use, unspecified, uncomplicated

F16
Block
0
Synonyms
231
LCDs
11
Payer Policies
0
Linked CPTs

About ICD-10-CM F16.90

ICD-10-CM code F16.90 represents Hallucinogen use, unspecified, uncomplicated. This is a billable/specific code in the Mental, Behavioral, and Neurodevelopmental chapter (block F16). The 2026 edition of ICD-10-CM F16.90 became effective on October 1, 2025.

Medicare LCD Coverage for F16.90

Local Coverage Determinations (LCDs) from CMS MACs that list F16.90 as a covered diagnosis.

231 LCDs

Showing top 10 of 231 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
Article ID: 56645, Effective: 2024-10-01 00:00:00, 1310 covered, 1 non-covered
CPT G0480 →
CMS LCD: Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
Article ID: 56645, Effective: 2024-10-01 00:00:00, 1310 covered, 1 non-covered
CPT G0481 →
CMS LCD: Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
Article ID: 56645, Effective: 2024-10-01 00:00:00, 1310 covered, 1 non-covered
CPT G0482 →
CMS LCD: Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
Article ID: 56645, Effective: 2024-10-01 00:00:00, 1310 covered, 1 non-covered
CPT G0483 →
CMS LCD: Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
Article ID: 56645, Effective: 2024-10-01 00:00:00, 1310 covered, 1 non-covered
CPT 80305 →
CMS LCD: Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
Article ID: 56645, Effective: 2024-10-01 00:00:00, 1310 covered, 1 non-covered
CPT G0659 →
CMS LCD: Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
Article ID: 56645, Effective: 2024-10-01 00:00:00, 1310 covered, 1 non-covered
CPT 80307 →
CMS LCD: Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
Article ID: 56645, Effective: 2024-10-01 00:00:00, 1310 covered, 1 non-covered
CPT 80306 →
CMS LCD: Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services
Article ID: 57520, Effective: 2025-01-01 00:00:00, 582 covered, 1 non-covered
CPT 90847 →
CMS LCD: Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services
Article ID: 57520, Effective: 2025-01-01 00:00:00, 582 covered, 1 non-covered
CPT G0560 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing F16.90.

11 policies

1 Cigna

Anesthesia Services for Interventional Pain Management Procedures in an Adult - (0551)
Policy ID: MM_0551

5 Medicare

Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
Policy ID: ART-56645
Billing and Coding: Urine Drug Testing
Policy ID: ART-56818
Billing and Coding: Psychiatry and Psychology Services
Policy ID: ART-56937
Billing and Coding: Outpatient Psychiatry and Psychology Services
Policy ID: ART-57065
Billing and Coding: Psychiatric Codes
Policy ID: ART-57130

1 Aetna

Tuberculosis Testing
Policy ID: CPB-0471

CPT Codes Commonly Billed with F16.90

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

No procedure linkages on file for F16.90

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.

Convert F16.90 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
F16.90 30530 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 F16.90, Billing FAQ

Is ICD-10 code F16.90 billable? +

Yes, F16.90 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What ICD-9 codes does F16.90 map to? +

Per CMS GEMs, F16.90 maps to ICD-9 codes: 30530. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on June 1, 2026.

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