Psychiatry Coding & Reimbursement Alert

Question: Our psychiatrist recently saw a patient for psychosis. The patient had a chronic history of alcoholism and a history of alcohol use for the past 15 years. Our clinician noted a family history of alcohol use. There is no family history of psychiatric problems. The diagnosis our clinician arrived at was alcohol induced psychosis. What codes should I use to report this diagnosis?

Maryland Subscriber

Answer:  When reporting a diagnosis of alcohol induced psychosis with ICD-9 codes, you will have to report it with 291.3 (Alcohol-induced psychotic disorder with hallucinations). When patients present with alcohol related factors that influence their health status, you should consider adding a V code to describe that scenario.

Since the patient has a personal history of alcoholism and a family history of alcohol use, you can look at the following V codes to report along with the diagnosis:

• V11.3 -- Personal history of alcoholism
• V61.41 -- Alcoholism in family

ICD-10: When you begin using ICD-10 codes after Oct.1, 2014, you will have to consider reporting the following equivalents instead of the above mentioned codes:

• 291.3 – F10.251 (Alcohol dependence with alcohol-induced psychotic disorder with hallucinations)
• V11.3 – Z65.8 (Other specified problems related to psychosocial circumstances)
• V61.41 – Z63.72 (Alcoholism and drug addiction in family)

Reminder: Alternatively, you can also consider using F10.151 (Alcohol abuse with alcohol-induced psychotic disorder with hallucinations) or F10.951 (Alcohol use, unspecified with alcohol-induced psychotic disorder with hallucinations) for a crosswalk from 291.3. However, this depends on the status of present and past alcohol use and level of intoxication when your clinician was seeing the patient.