Understanding Drug-Induced Psychosis (Substance-Induced Psychotic Disorder, Toxic Psychosis) is crucial for accurate clinical documentation and medical coding. This resource provides information on diagnosing, documenting, and coding D-letter diagnoses related to substance-induced psychotic disorders, including relevant ICD-10 codes and best practices for healthcare professionals. Learn about the symptoms, diagnostic criteria, and treatment options for Drug-Induced Psychosis and ensure proper medical record keeping.
Also known as
Mental and behavioural disorders due to psychoactive substance use
Covers various mental disorders, including psychosis, caused by drug use.
Schizophrenia, schizotypal and delusional disorders
Includes disorders with psychotic features, sometimes mimicking substance-induced psychosis.
Mood affective disorders
Substance use can induce mood episodes with psychotic features, covered here.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the psychosis clearly due to drug use?
When to use each related code
| Description |
|---|
| Psychosis caused by drug use. |
| Psychosis with no known cause. |
| Brief psychosis lasting less than a month. |
Lack of proper documentation specifying the causative substance leading to inaccurate coding and potential underpayment.
Misdiagnosis or failure to code underlying psychiatric conditions along with the drug-induced psychosis, impacting reimbursement.
Insufficient documentation of onset and duration related to substance use, impacting accurate coding and compliance audits.
Q: How can I differentiate between Drug-Induced Psychosis and primary psychotic disorders like Schizophrenia when evaluating a patient exhibiting psychotic symptoms?
A: Differentiating between Drug-Induced Psychosis (Substance-Induced Psychotic Disorder) and primary psychotic disorders like Schizophrenia requires a thorough clinical evaluation encompassing a detailed substance use history, timeline of symptom onset, and careful assessment of the psychotic symptoms. A key indicator is the temporal relationship between substance use and the onset of psychosis. In Drug-Induced Psychosis, psychotic symptoms typically emerge shortly after substance intoxication or withdrawal, whereas in Schizophrenia, psychosis develops more insidiously and persists beyond periods of substance use. Furthermore, the specific psychotic symptoms can offer clues. For example, visual hallucinations are more common in substance-induced conditions, while auditory hallucinations are more characteristic of Schizophrenia. However, significant overlap exists, making diagnosis challenging. Consider incorporating standardized assessment tools like the Brief Psychiatric Rating Scale (BPRS) and thorough physical examinations, including laboratory tests to screen for substance use, to aid in differential diagnosis. Explore how integrating comprehensive patient history and objective assessment tools can improve diagnostic accuracy in challenging cases.
Q: What are the most effective evidence-based treatment strategies for managing acute psychosis induced by stimulants like amphetamines or cocaine?
A: Managing acute stimulant-induced psychosis, whether caused by amphetamines or cocaine, requires a multi-pronged approach prioritizing patient safety and symptom stabilization. Pharmacological interventions, such as benzodiazepines for agitation and anxiety, and antipsychotics for managing psychotic symptoms like hallucinations and delusions, are often crucial in the acute phase. However, the choice and dosage of antipsychotics should be carefully considered based on the patient's individual presentation and potential drug interactions. Beyond medication, creating a calm and supportive environment is essential to minimize external stimuli that can exacerbate psychosis. Close monitoring for potential complications, including cardiovascular instability and seizures, is also crucial. Once the acute phase subsides, consider implementing psychotherapeutic interventions, including cognitive behavioral therapy (CBT) and motivational interviewing, to address underlying substance use issues and prevent relapse. Learn more about the role of harm reduction strategies in long-term management of stimulant-induced psychosis.
Patient presents with symptoms consistent with Drug-Induced Psychosis (Substance-Induced Psychotic Disorder, Toxic Psychosis). Onset of psychotic symptoms, including hallucinations (auditory, visual, tactile), delusions (persecutory, grandiose, bizarre), disorganized thinking, and abnormal behavior, appears temporally related to the initiation, change in dosage, or discontinuation of prescribed medication or substance use. Substances considered include but are not limited to alcohol, cannabis, stimulants (amphetamine, cocaine), hallucinogens (LSD, PCP), opioids, and certain prescription medications (steroids, anticholinergics). Differential diagnosis includes primary psychotic disorders such as schizophrenia and schizoaffective disorder. The patient's mental status examination reveals (document specific findings e.g., disorientation, impaired judgment, labile affect). Family history is negative for primary psychotic disorders. Laboratory tests were ordered to rule out other medical conditions and substance toxicology screens are pending. Current medication list reviewed. Assessment suggests the psychosis is likely secondary to substance use or medication. The patient's presentation meets the DSM-5 criteria for Drug-Induced Psychosis. Treatment plan includes discontinuation of the offending substance (if applicable) under medical supervision, initiation of antipsychotic medication for symptom management, and close monitoring for potential withdrawal symptoms. Patient education regarding substance abuse and medication adherence provided. Referral to substance abuse counseling and psychiatric follow-up scheduled. Prognosis guarded, dependent on substance use cessation and treatment adherence. ICD-10 code F1x.5xx (specify substance) and CPT codes for psychiatric evaluation and management (9920x-9921x, dependent on complexity) will be used for billing and coding purposes.