F13.251
Sedative, hypnotic or anxiolytic dependence with sedative, hypnotic or anxiolytic-induced psychotic disorder with hallucinations
F13.251 (also written F13251) is a billable ICD-10-CM diagnosis code for sedative, hypnotic or anxiolytic dependence with sedative, hypnotic or anxiolytic-induced psychotic disorder with hallucinations. It is part of the FY2027 code set, effective October 1, 2026. It is one of the 58 codes in category F13 (Sedative, hypnotic, or anxiolytic related disorders). The Alphabetic Index lists it under 2 entries. Its coding notes include 2 Excludes1 entries and 2 Excludes2 entries.
Guidelines tips
From the FY2027 Official Guidelines. ICD10Ref adds no rules of its own.
When use, abuse and dependence of the same substance are all documented, one code is assigned, by a set hierarchy.
A medical condition due to substance use is coded from the Alphabetic Index along with the substance use, abuse or dependence code, not as a substance-induced disorder.
Excludes1
Not coded here. The listed conditions generally should not be reported together.
Excludes2
Not included here. Both codes may be reported if the patient has both conditions.
- sedative, hypnotic, or anxiolytic poisoning (T42.-)
Also from chapter/block level (1 note)
- symptoms, signs and abnormal clinical laboratory findings, not elsewhere classified (R00-R99)
Care settings
How CMS programs treat this code. These are CMS claim edits and list entries, not coverage or eligibility rules.
Home Health Primary
Accepted as the primary (principal) diagnosis on a home health claim. The Home Health Grouper assigns it to the Behavioral Health clinical group.
Source: CMS Home Health Grouper Software v07.2.26, effective October 1, 2026Hospital CC
Counts as a complication or comorbidity (CC) when reported as a secondary diagnosis on an inpatient claim. It does not count when the principal diagnosis is one of the 463 codes in its exclusion list. Some MS-DRGs also ignore a CC or MCC that defines the DRG.
Source: CMS MS-DRG Definitions Manual v44, effective October 1, 2026, Appendix CIPF Primary
IPF MS-DRG adjustment. A principal diagnosis of this code groups to one of these MS-DRGs. Which one depends on other facts of the stay, so the factor is a range:
| MS-DRG | Description | Factor |
|---|---|---|
| 894 | Alcohol/drug abuse or dependence, left AMA | 0.86 |
| 895 | Alcohol/drug abuse or dependence w rehabilitation therapy | 0.90 |
| 896 | Alcohol/drug abuse or dependence w/o rehabilitation therapy w MCC | 1.00 |
| 897 | Alcohol/drug abuse or dependence w/o rehabilitation therapy w/o MCC | 0.95 |
Includes
Further defines or gives examples of the content of the category.
Also from chapter/block level (1 note)
- disorders of psychological development
Alphabetic Index terms
Terms the official Alphabetic Index lists for this code. 2 entries