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

ICD-10 F18.250

Billable / Specific HCC v28: 54 CC

Inhalant dependence with inhalant-induced psychotic disorder with delusions

F18
Block
0
Synonyms
342
LCDs
18
Payer Policies
0
Linked CPTs

About ICD-10-CM F18.250

ICD-10-CM code F18.250 represents Inhalant dependence with inhalant-induced psychotic disorder with delusions. This is a billable/specific code in the Mental, Behavioral, and Neurodevelopmental chapter (block F18). The 2026 edition of ICD-10-CM F18.250 became effective on October 1, 2025.

Coding Tips for F18.250

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

HCC capture: document with MEAT each year

F18.250 is a CMS-HCC v28 risk-adjustment code (category 54). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.

Inpatient DRG impact: CC

F18.250 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.

Medicare Advantage HCC Impact

CMS-HCC v28 (current)
Category 54
ESRD-HCC
Category 54
RxHCC (Part D)
Category 54

Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.

Inpatient DRG Impact, CC

codes Inhalant dependence with inhalant-induced psychotic disorder with delusions. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.

Medicare LCD Coverage for F18.250

Local Coverage Determinations (LCDs) from CMS MACs that list F18.250 as a covered diagnosis.

342 LCDs

Showing top 10 of 342 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Psychiatric Inpatient Hospitalization
Article ID: 57052, Effective: 2026-03-26 00:00:00, 422 covered, 0 non-covered
CPT XX000 →
CMS LCD: Billing and Coding: Home Health - Psychiatric Care
Article ID: 56756, Effective: 2023-11-09 00:00:00, 595 covered, 0 non-covered
CPT G0156 →
CMS LCD: Billing and Coding: Home Health - Psychiatric Care
Article ID: 56756, Effective: 2023-11-09 00:00:00, 595 covered, 0 non-covered
CPT G0299 →
CMS LCD: Billing and Coding: Home Health - Psychiatric Care
Article ID: 56756, Effective: 2023-11-09 00:00:00, 595 covered, 0 non-covered
CPT G0152 →
CMS LCD: Billing and Coding: Home Health - Psychiatric Care
Article ID: 56756, Effective: 2023-11-09 00:00:00, 595 covered, 0 non-covered
CPT G0155 →
CMS LCD: Billing and Coding: Home Health - Psychiatric Care
Article ID: 56756, Effective: 2023-11-09 00:00:00, 595 covered, 0 non-covered
CPT G0300 →
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 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing F18.250.

18 policies

5 Medicare

Billing and Coding: Psychiatric Inpatient Hospitalization
Policy ID: ART-56614
Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
Policy ID: ART-56645
Billing and Coding: Partial Hospitalization Programs
Policy ID: ART-56685
Billing and Coding: Home Health - Psychiatric Care
Policy ID: ART-56756
Billing and Coding: Urine Drug Testing
Policy ID: ART-56818

CPT Codes Commonly Billed with F18.250

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

No procedure linkages on file for F18.250

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 F18.250 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
F18.250 29211 10111
F18.250 30460 10112

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

ICD-10 F18.250, Billing FAQ

Is ICD-10 code F18.250 billable? +

Yes, F18.250 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Does F18.250 affect Medicare Advantage HCC risk adjustment? +

Yes. F18.250 maps to CMS-HCC v28 category 54. Capture this diagnosis annually for accurate Medicare Advantage risk score.

Is F18.250 a CC or MCC for inpatient DRG? +

Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.

What ICD-9 codes does F18.250 map to? +

Per CMS GEMs, F18.250 maps to ICD-9 codes: 29211, 30460. 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 May 31, 2026.

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