ICD-10 F19.1
Non-Billable HeaderOther psychoactive substance abuse
About ICD-10-CM F19.1
ICD-10-CM code F19.1 represents Other psychoactive substance abuse. This is a non-billable header code in the Mental, Behavioral, and Neurodevelopmental chapter (block F19). The 2026 edition of ICD-10-CM F19.1 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.
Type 1 Excludes
Pure excludes, these codes can never be coded together with F19.1. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- other psychoactive substance dependence (F19.2-)
- other psychoactive substance use, unspecified (F19.9-)
Medicare LCD Coverage for F19.1
Local Coverage Determinations (LCDs) from CMS MACs that list F19.1 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 F19.1.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but F19.1 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with F19.1
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 F19.1
Other codes in section F10-F19 (Mental and behavioral disorders due to psychoactive substance use).
ICD-10 F19.1, Billing FAQ
Is ICD-10 code F19.1 billable? +
No, F19.1 is a non-billable header code. Use a more specific child code from block F19 when submitting claims.
What codes are Type 1 Excludes for F19.1? +
Type 1 Excludes (never code together with F19.1): other psychoactive substance dependence (F19.2-); other psychoactive substance use, unspecified (F19.9-)
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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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