CCW Task Order 16: Round 3 Clinical Condition Algorithms. Page 1 of 5 ICD-9 CODE DESCRIPTION ICD-9 CODE

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1 DESCRIPTION 292 Drug-induced mental disorders 2920 Drug withdrawal Drug-induced psychotic disorder with delusions Drug-induced psychotic disorder with hallucinations 2922 Pathological drug intoxication 2928 Other specified drug-induced mental disorders Drug-induced delirium Drug-induced persisting dementia Drug-induced persisting amnestic disorder Drug-induced mood disorder Drug induced sleep disorders Other specified drug-induced mental disorders 2929 Unspecified drug-induced mental disorder 304 Drug dependence 3040 Opioid type dependence Opioid type dependence, continuous Opioid type dependence, episodic Opioid type dependence, in remission 3041 Sedative, hypnotic or anxiolytic dependence, unspecified Sedative, hypnotic or anxiolytic dependence, continuous Sedative, hypnotic or anxiolytic dependence, episodic Sedative, hypnotic or anxiolytic dependence, in remission 3042 Cocaine dependence Cocaine dependence, unspecified Cocaine dependence, continuous Cocaine dependence, episodic Cocaine dependence, in remission 3043 Cannabis dependence Cannabis dependence, unspecified Page 1 of 5

2 DESCRIPTION Cannabis dependence, continuous Cannabis dependence, episodic Cannabis dependence, in remission 3044 Amphetamine and other psychostimulant dependence Amphetamine and other psychostimulant dependence, unspecified Amphetamine and other psychostimulant dependence, continuous Amphetamine and other psychostimulant dependence, episodic Amphetamine and other psychostimulant dependence, in remission 3045 Hallucinogen dependence Hallucinogen dependence, unspecified Hallucinogen dependence, continuous Hallucinogen dependence, episodic Hallucinogen dependence, in remission 3046 Other specified drug dependence Other specified drug dependence, unspecified Other specified drug dependence, continuous Other specified drug dependence, episodic Other specified drug dependence, in remission 3047 Combinations of opioid type drug with any other drug dependence Combinations of opioid type drug with any other drug dependence, unspecified Combinations of opioid type drug with any other drug dependence, continuous Combinations of opioid type drug with any other drug dependence, episodic Combinations of opioid type drug with any other drug dependence, in remission 3048 Combinations of drug dependence excluding opioid type drug Combinations of drug dependence excluding opioid type drug, unspecified Combinations of drug dependence excluding opioid type drug, continuous Combinations of drug dependence excluding opioid type drug, episodic Combinations of drug dependence excluding opioid type drug, in remission 3049 Unspecified drug dependence Page 2 of 5

3 30490 Unspecified drug dependence, unspecified Unspecified drug dependence, continuous Unspecified drug dependence, episodic Unspecified drug dependence, in remission 305 Nondependent abuse of drugs 3052 Cannabis abuse Cannabis abuse, unspecified Cannabis abuse, continuous Cannabis abuse, episodic Cannabis abuse, in remission 3053 Hallucinogen abuse Hallucinogen abuse, unspecified Hallucinogen abuse, continuous Hallucinogen abuse, episodic Hallucinogen abuse, in remission 3054 Sedative, hypnotic or anxiolytic abuse Sedative, hypnotic or anxiolytic abuse, unspecified Sedative, hypnotic or anxiolytic abuse, continuous Sedative, hypnotic or anxiolytic abuse, episodic Sedative, hypnotic or anxiolytic abuse, in remission 3055 Opioid abuse Opioid abuse, unspecified Opioid abuse, continuous Opioid abuse, episodic Opioid abuse, in remission 3056 Cocaine abuse Cocaine abuse, unspecified Cocaine abuse, continuous Cocaine abuse, episodic DESCRIPTION Page 3 of 5

4 DESCRIPTION Cocaine abuse, in remission 3057 Amphetamine or related acting sympathomimetic abuse Amphetamine or related acting sympathomimetic abuse, unspecified Amphetamine or related acting sympathomimetic abuse, continuous Amphetamine or related acting sympathomimetic abuse, episodic Amphetamine or related acting sympathomimetic abuse, in remission 3058 Antidepressant type abuse Antidepressant type abuse, unspecified Antidepressant type abuse, continuous Antidepressant type abuse, episodic Antidepressant type abuse, in remission 3059 Other, mixed, or unspecified drug abuse Other, mixed, or unspecified drug abuse, unspecified Other, mixed, or unspecified drug abuse, continuous Other, mixed, or unspecified drug abuse, episodic Other, mixed, or unspecified drug abuse, in remission 6483 Drug dependence of mother Drug dependence of mother, unspecified as to episode of care or not applicable Drug dependence of mother, delivered, with or without mention of antepartum condition Drug dependence of mother, delivered, with mention of postpartum complication Drug dependence of mother, antepartum condition or complication Drug dependence of mother, postpartum condition or complication 6555 Suspected damage to the fetus from drugs Suspected damage to the fetus from drugs; unspecified as to the episode of care (N/A) Suspected damage to the fetus from drugs delivered; with or without mention of antepartum condition Suspected damage to the fetus from drugs; antepartum condition or complication Narcotics affecting fetus or newborn via placenta or breast milk Hallucinogenic agents affecting fetus or newborn via placenta or breast milk Cocaine affecting fetus or newborn via placenta or breast milk Page 4 of 5

5 DESCRIPTION 7795 Drug withdrawal syndrome in a newborn 9650 Poisonings by opiates and related narcotics Poisonings by opium, unspecified Poisonings by heroin Poisonings by methadone Poisoning by other opiate and related narcotic V6542 Counseling on substance use and abuse Screening code, therefore this code requires a second ing claim that is not V6542 (a screening code) 946 Alcohol and drug rehabilitation and detoxification This procedure code requires only one claim to 9464 Procedure code - Drug rehabilitation This procedure code requires only one claim to 9465 Procedure code - Drug detoxification This procedure code requires only one claim to 9466 Procedure code - Drug rehabilitation and detoxification This procedure code requires only one claim to 9467 Procedure code - Combined alcohol and drug rehabilitation This procedure code requires only one claim to 9468 Procedure code - Combined alcohol and drug detoxification This procedure code requires only one claim to 9469 Procedure code - Combined alcohol and drug rehabilitation and detoxification This procedure code requires only one claim to E850.0 Accidental poisoning by heroin E850.1 Accidental poisoning by methadone E850.2 Accidental Opiate Poisoning (Excludes heroin and methadone) E854.1 Accidental poisoning by hallucinogens E935.0 Adverse effects of heroin E935.1 Adverse effects of methadone Page 5 of 5