Code Attributes
- Non-Billable/Non-Specific Code
Clinical Information
- Excessive use of marijuana with associated psychological symptoms and impairment in social or occupational functioning.
- Marijuana is a dry, shredded mix of flowers, stems, seeds and leaves of the hemp plant cannabis sativa. People usually smoke it as a cigarette or in a pipe. It is the most commonly abused illegal drug in the United States.abusing marijuana can result in problems with memory, learning and social behavior. It can interfere with family, school, work and other activities. Scientific studies are underway to test the safety and usefulness of cannabis compounds for treating certain medical conditions. Currently, smoking marijuana is not recommended for the treatment of any disease or condition. nih: national institute on drug abuse
- The excessive use of marijuana with associated psychological symptoms and impairment in social or occupational functioning.
Includes:
- Marijuana
Codes
- F12.1 Cannabis abuse
- F12.10 Cannabis abuse, uncomplicated
- F12.11 Cannabis abuse, in remission
- F12.12 Cannabis abuse with intoxication
- F12.120 Cannabis abuse with intoxication, uncomplicated
- F12.121 Cannabis abuse with intoxication delirium
- F12.122 Cannabis abuse with intoxication with perceptual disturbance
- F12.129 Cannabis abuse with intoxication, unspecified
- F12.13 Cannabis abuse with withdrawal
- F12.15 Cannabis abuse with psychotic disorder
- F12.150 Cannabis abuse with psychotic disorder with delusions
- F12.151 Cannabis abuse with psychotic disorder with hallucinations
- F12.159 Cannabis abuse with psychotic disorder, unspecified
- F12.18 Cannabis abuse with other cannabis-induced disorder
- F12.180 Cannabis abuse with cannabis-induced anxiety disorder
- F12.188 Cannabis abuse with other cannabis-induced disorder
- F12.19 Cannabis abuse with unspecified cannabis-induced disorder
- F12.2 Cannabis dependence
- F12.20 Cannabis dependence, uncomplicated
- F12.21 Cannabis dependence, in remission
- F12.22 Cannabis dependence with intoxication
- F12.220 Cannabis dependence with intoxication, uncomplicated
- F12.221 Cannabis dependence with intoxication delirium
- F12.222 Cannabis dependence with intoxication with perceptual disturbance
- F12.229 Cannabis dependence with intoxication, unspecified
- F12.23 Cannabis dependence with withdrawal
- F12.25 Cannabis dependence with psychotic disorder
- F12.250 Cannabis dependence with psychotic disorder with delusions
- F12.251 Cannabis dependence with psychotic disorder with hallucinations
- F12.259 Cannabis dependence with psychotic disorder, unspecified
- F12.28 Cannabis dependence with other cannabis-induced disorder
- F12.280 Cannabis dependence with cannabis-induced anxiety disorder
- F12.288 Cannabis dependence with other cannabis-induced disorder
- F12.29 Cannabis dependence with unspecified cannabis-induced disorder
- F12.9 Cannabis use, unspecified
- F12.90 Cannabis use, unspecified, uncomplicated
- F12.91 Cannabis use, unspecified, in remission
- F12.92 Cannabis use, unspecified with intoxication
- F12.920 Cannabis use, unspecified with intoxication, uncomplicated
- F12.921 Cannabis use, unspecified with intoxication delirium
- F12.922 Cannabis use, unspecified with intoxication with perceptual disturbance
- F12.929 Cannabis use, unspecified with intoxication, unspecified
- F12.93 Cannabis use, unspecified with withdrawal
- F12.95 Cannabis use, unspecified with psychotic disorder
- F12.950 Cannabis use, unspecified with psychotic disorder with delusions
- F12.951 Cannabis use, unspecified with psychotic disorder with hallucinations
- F12.959 Cannabis use, unspecified with psychotic disorder, unspecified
- F12.98 Cannabis use, unspecified with other cannabis-induced disorder
- F12.980 Cannabis use, unspecified with anxiety disorder
- F12.988 Cannabis use, unspecified with other cannabis-induced disorder
- F12.99 Cannabis use, unspecified with unspecified cannabis-induced disorder
The ICD-10 Code F12 relates to disorders due to the use of cannabinoids. In the context of mental health diagnosis, coding, and billing, it's crucial to accurately apply and understand this code for proper insurance claims and patient documentation.
Here's a structured breakdown to help you navigate this:
1. Specificity is key
The F12 category is broad and includes a number of subcategories that range from acute intoxication (F12.0) to dependence syndrome (F12.2), and even psychotic disorders (F12.5), among others. Being specific about the subcategory when diagnosing is vital for accurate billing and documentation. Each subcategory has its unique characteristics and implications for treatment planning and billing.
2. Documentation
Make sure that your diagnosis is well-documented in the client's record. Include detailed notes supporting the diagnosis, which are critical when submitting claims to insurance companies. Proper documentation helps in justifying the treatment approach and facilitates smoother approval of claims.
3. Billing and insurance claims
When preparing to bill for services provided to a client with a diagnosis falling under the F12 category, you must:
- Verify the client's insurance coverage for treatments related to substance use disorders, as coverage can vary significantly among policies.
- Use the specific F12 subcategory code on claims forms. Accuracy in these codes helps prevent claim rejections or denials due to unspecified or incorrect coding.
- Include any relevant procedure codes (CPT codes) that correspond to the services you provided. These could range from individual psychotherapy (e.g., 90837 for a 60-minute session) to group therapy or other interventions.
4. Pre-authorization
Some insurance providers require pre-authorization for treatment of substance use disorders. Track authorization numbers and session counts to ensure compliance with the insurer’s requirements. Always check with the client's insurance for any pre-authorization requirements before beginning treatment.
5. Continuing education and support
Stay informed about any changes to the ICD-10 codes and insurance billing practices by subscribing to news from official resources. Check out relevant webinars, articles, and support documents that help practitioners stay current on best practices in billing and coding.
Sources
- "NCI Metathesaurus". NIH - NCI Metathesaurus. National Cancer Institute, n.d., https://ncit.nci.nih.gov/ncitbrowser/ConceptReport.jsp?dictionary=NCI%20Metathesaurus&code=C0024809. Accessed 27 Jan 2025.
- "2025 ICD-10-CM Diagnosis Code F12: Cannabis related disorders". ICD10Data. ICD10Data, n.d., https://www.icd10data.com/ICD10CM/Codes/F01-F99/F10-F19/F12-/F12. Accessed 27 Jan 2025.
- "2025 ICD-10-CM Diagnosis Code F12: Cannabis related disorders". ICD10Data. ICD10Data, n.d., https://www.icd10data.com/ICD10CM/Codes/F01-F99/F10-F19/F12-/F12. Accessed 27 Jan 2025.
- "ICD-10 Code for Cannabis related disorders- F12- Codify by AAPC". Codify By AAPC. American Academy of Professional Coders, n.d., https://www.aapc.com/codes/icd-10-codes/F12. Accessed 27 Jan 2025.
