ICD-10 Codes: G30.9 and F19.10

The ICD-10-CM (International Classification of Diseases, Tenth Revision, Clinical Modification) codes G30.9 and F19.10 are used in healthcare for diagnostic and reimbursement purposes. G30.9 specifically refers to "Alzheimer's disease, unspecified," while F19.10 denotes "Other psychoactive substance abuse, uncomplicated." Both codes became effective for the 2025 edition of ICD-10-CM on October 1, 2024 [1], [3].

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Alzheimer's disease (AD) is a progressive, neurodegenerative disorder characterized by the insidious onset of dementia, leading to a decline in memory, cognition, behavior, and social skills [2], [4]. It is the most common cause of dementia among older adults, accounting for an estimated 60%-70% of dementia cases [4]. Pathologically, AD is marked by severe cortical atrophy and the presence of senile plaques, neurofibrillary tangles, and neuropil threads [1], [2]. While AD typically begins after age 60, early-onset forms can occur between ages 30 and mid-60s, though these are rare [4].

Coding for Alzheimer's disease often requires the use of two codes due to the etiology/manifestation convention in ICD-10-CM [4]. The primary code, G30.9, identifies the underlying Alzheimer's disease [1], [4]. A secondary code from category F02, "Dementia in other diseases classified elsewhere," is then used to specify the type and characteristics of the dementia, such as severity (mild, moderate, severe, unspecified), and the presence or absence of behavioral disturbances, psychotic disturbances, mood disturbances, or anxiety [2], [4]. For example, "Alzheimer's dementia without behavioral disturbance" would be coded with G30.9 and F02.80 [1]. The "Use Additional" note under G30.9 indicates that codes for delirium (F05), various forms of dementia with or without behavioral disturbances (F02.80, F02.A0, F02.B0, F02.C0, F02.81-, F02.A1-, F02.B1-, F02.C1-), mood disturbances (F02.83, F02.A3, F02.B3, F02.C3), psychotic disturbances (F02.82, F02.A2, F02.B2, F02.C2), and mild neurocognitive disorder due to known physiological conditions (F06.7-) should be used if applicable [1], [5]. It is crucial to note that G30 itself is a non-billable, non-specific code, meaning more detailed codes like G30.9 are required for reimbursement [2].

F19.10, on the other hand, is a billable and specific code used to classify uncomplicated abuse of psychoactive substances not categorized under specific substances like alcohol, opioids, cannabis, sedatives, hypnotics, cocaine, or other specified stimulants, hallucinogens, or inhalants [3], [6], [7]. The term "uncomplicated" signifies that the abuse is not accompanied by complications such as withdrawal symptoms, delirium, or other substance-induced disorders [6]. This code is applied when an individual engages in recurrent use of an unspecified psychoactive substance, leading to issues like failure to fulfill major obligations, use in hazardous situations, legal problems, or interpersonal problems, but without meeting criteria for substance dependence or more severe medical/psychiatric complications [6]. Relevant CPT (Current Procedural Terminology) codes for treatment and management associated with F19.10 may include evaluation and management services (99201-99215), psychotherapy services (90832-90838), and various substance abuse assessment and intervention services (H0001, H0004, H0038, G0396-G0397, 99408-99409) [6].

Both G30.9 and F19.10 fall under broader ICD-10-CM ranges. G30.9 is part of the G00-G99 range, which covers "Diseases of the nervous system" [1], [2]. F19.10 is within the F01-F99 range, encompassing "Mental, Behavioral and Neurodevelopmental disorders" [3]. For accurate coding and reimbursement, healthcare providers must consult the official ICD-10-CM guidelines and ensure documentation supports the assigned codes [4], [8].

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