Quick reference
- When to use
- Use F15.20 when the client meets criteria for Stimulant Use Disorder, Moderate. Determine severity by symptom count: mild (2-3), moderate (4-5), severe (6+). Specify current status: in early remission, in sustained remission, or on maintenance therapy.
- Duration
- Early remission: 3-12 months without criteria met (except craving). Sustained remission: 12+ months. On maintenance therapy: receiving agonist medication. Tolerance/withdrawal don't count if on prescribed medication.
- Session codes
- Pair with CPT 90834/90837 for therapy. SBIRT: 99408/99409. Medication management: 99213/99214. Group therapy: 90853. Use 96127 for AUDIT/DAST screening. MAT visits may use specific E/M codes.
- Key indicators
- Impaired control over substance use • Social impairment • Risky use • Pharmacological indicators (tolerance, withdrawal) • Craving • Continued use despite problems • Giving up activities
What F15.20 represents
Covers misuse of stimulant substances including amphetamines, methamphetamine, cocaine, and prescription stimulants. A growing concern given increasing stimulant prescriptions and methamphetamine use.
Key diagnostic criteria
Standard substance use disorder criteria applied to stimulant use. 4-5 criteria met for moderate severity. Note: DSM-5 combined amphetamine-type and cocaine use disorders.
Documentation essentials
Specify the stimulant(s) used. Document route of administration. Record criteria met and functional impact.
Differential diagnosis
Distinguish from ADHD treated with stimulants, bipolar mania, stimulant-induced psychosis.
Treatment planning
Contingency management, CBT, community reinforcement approach. No FDA-approved medications currently for stimulant use disorder.
Insurance & billing
Accepted code. Specify stimulant type in documentation.
Updates & changes
DSM-5 combined cocaine and amphetamine use disorders into stimulant use disorder.
Documentation pitfalls
Distinguish from appropriate medical use of prescription stimulants for ADHD.
References
- American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.).