ICD-10 F55
Non-Billable HeaderAbuse of non-psychoactive substances
About ICD-10-CM F55
ICD-10-CM code F55 represents Abuse of non-psychoactive substances. This is a non-billable header code in the Mental, Behavioral, and Neurodevelopmental chapter (block F55). The 2026 edition of ICD-10-CM F55 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 2 Excludes
Not included here, the excluded code is not part of F55, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.
- abuse of psychoactive substances (F10-F19)
Medicare LCD Coverage for F55
Local Coverage Determinations (LCDs) from CMS MACs that list F55 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 F55.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but F55 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with F55
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 F55
Other codes in section F50-F59 (Behavioral syndromes associated with physiological disturbances and physical factors).
ICD-10 F55, Billing FAQ
Is ICD-10 code F55 billable? +
No, F55 is a non-billable header code. Use a more specific child code from block F55 when submitting claims.
What codes are Type 2 Excludes for F55? +
Type 2 Excludes (may be coded together when both conditions exist): abuse of psychoactive substances (F10-F19)
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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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