ORGANIC PSYCHOTIC CONDITIONS (290-294)

• Includes: psychotic organic brain syndrome
• Excludes: nonpsychotic syndromes of organic etiology (310.0-310.9)
  • psychoses classifiable to 295-298 and without impairment of orientation, comprehension, calculation, learning capacity, and judgement, but associated with physical disease, injury, or condition affecting the brain [e.g., following childbirth] (295.0-298.8)
• 290 Senile and presenile organic psychotic conditions
  • Use additional code to identify the associated neurological conditions, as:
    • Alzheimer's disease (331.0)
    • Jakob-Creutzfeldt disease (046.1)
    • Pick's disease of the brain (331.1)
  • Excludes: dementia not classified as senile, presenile, or arteriosclerotic (294.1)
    • psychoses classifiable to 295-298 occurring in the senium without dementia or delirium (295.0-298.8)
    • senility with mental changes of nonpsychotic severity (310.1)
    • transient organic psychotic conditions (293.0-293.9)
  • 290.0 Senile dementia, uncomplicated
    • Senile dementia:
      • NOS
      • simple type
    • Excludes: mild memory disturbances, not amounting to dementia, associated with senile brain disease (310.1)
      • senile dementia with:
        • delirium or confusion (290.3)
        • delusional [paranoid] features (290.20)
        • depressive features (290.21)
  • 290.1 Presenile dementia
    • Brain syndrome with presenile brain disease
    • Dementia in:
      • Alzheimer's disease
      • Jakob-Creutzfeldt disease
      • Pick's disease of the brain
    • Excludes: arteriosclerotic dementia (290.40-290.43)
      • dementia associated with other cerebral conditions (294.1)
    • 290.10 Presenile dementia, uncomplicated
      • Presenile dementia:
        • NOS
        • simple type
    • 290.11 Presenile dementia with delirium
      • Presenile dementia with acute confusional state
    • 290.12 Presenile dementia with delusional features
      • Presenile dementia, paranoid type
    • 290.13 Presenile dementia with depressive features
      • Presenile dementia, depressed type
  • 290.2 Senile dementia with delusional or depressive features
    • Excludes: senile dementia:
      • NOS (290.0)
      • with delirium and/or confusion (290.3)
    • 290.20 Senile dementia with delusional features
      • Senile dementia, paranoid type
      • Senile psychosis NOS
    • 290.21 Senile dementia with depressive features
  • 290.3 Senile dementia with delirium
    • Senile dementia with acute confusional state
    • Excludes: senile:
      • dementia NOS (290.0)
      • psychosis NOS (290.20)
  • 290.4 Arteriosclerotic dementia
    • Multi-infarct dementia or psychosis
    • Use additional code to identify cerebral atherosclerosis (437.0)
    • Excludes: suspected cases with no clear evidence of arteriosclerosis (290.9)
    • 290.40 Arteriosclerotic dementia,uncomplicated
      • Arteriosclerotic dementia:
        • NOS
        • simple type
    • 290.41 Arteriosclerotic dementia with delirium
      • Arteriosclerotic dementia with acute confusional state
    • 290.42 Arteriosclerotic dementia with delusional features
      • Arteriosclerotic dementia, paranoid type
    • 290.43 Arteriosclerotic dementia with depressive features
      • Arteriosclerotic dementia, depressed type
  • 290.8 Other specified senile psychotic conditions
    • Presbyophrenic psychosis
  • 290.9 Unspecified senile psychotic condition
• 291 Alcoholic psychoses
  • Excludes: alcoholism without psychosis (303.0-303.9)
  • 291.0 Alcohol withdrawal delirium
    • Alcoholic delirium
    • Delirium tremens
  • 291.1 Alcohol amnestic syndrome
    • Alcoholic polyneuritic psychosis
    • Korsakoff's psychosis, alcoholic
    • Wernicke-Korsakoff syndrome (alcoholic)
  • 291.2 Other alcoholic dementia
    • Alcoholic dementia NOS
    • Alcoholism associated with dementia NOS
    • Chronic alcoholic brain syndrome
  • 291.3 Alcohol withdrawal hallucinosis
    • Alcoholic:
      • hallucinosis (acute)
      • psychosis with hallucinosis
    • Excludes: alcohol withdrawal with delirium (291.0)
      • schizophrenia (295.0-295.9) and paranoid states (297.0-297.9) taking the form of chronic hallucinosis with clear consciousness in an alcoholic
  • 291.4 Idiosyncratic alcohol intoxication
    • Pathologic:
      • alcohol intoxication
      • drunkenness
    • Excludes: acute alcohol intoxication (305.0)
      • in alcoholism (303.0)
      • simple drunkenness (305.0)
  • 291.5 Alcoholic jealousy
    • Alcoholic:
      • paranoia
      • psychosis, paranoid type
    • Excludes: nonalcoholic paranoid states (297.0-297.9)
      • schizophrenia, paranoid type (295.3)
  • 291.8 Other specified alcoholic psychosis
    • Alcohol:
      • abstinence syndrome or symptoms
      • withdrawal syndrome or symptoms
    • Excludes: alcohol withdrawal:
      • delirium (291.0)
      • hallucinosis (291.3)
      • delirium tremens (291.0)
  • 291.9 Unspecified alcoholic psychosis
    • Alcoholic:
      • mania NOS
      • psychosis NOS
    • Alcoholism (chronic) with psychosis
• 292 Drug psychoses
  • Includes: drug-induced mental disorders
    • organic brain syndrome associated with consumption of drugs
  • Use additional code for any associated drug dependence (304.0-304.9)
  • Use additional E code to identify drug
  • 292.0 Drug withdrawal syndrome
    • Drug:
      • abstinence syndrome or symptoms
      • withdrawal syndrome or symptoms
  • 292.1 Paranoid and/or hallucinatory states induced by drugs
    • 292.11 Drug-induced organic delusional syndrome
      • Paranoid state induced by drugs
    • 292.12 Drug-induced hallucinosis
      • Hallucinatory state induced by drugs
      • Excludes: states following LSD or other hallucinogens, lasting only a few days or less ["bad trips"] (305.3)
  • 292.2 Pathological drug intoxication
    • Drug reaction resulting in brief psychotic states
      • NOS
      • idiosyncratic
      • pathologic
    • Excludes: expected brief psychotic reactions to hallucinogens ["bad trips"] (305.3)
      • physiological side-effects of drugs (e.g., dystonias)
  • 292.8 Other specified drug-induced mental disorders
    • 292.81 Drug-induced delirium
    • 292.82 Drug-induced dementia
    • 292.83 Drug-induced amnestic syndrome
    • 292.84 Drug-induced organic affective syndrome
      • Depressive state induced by drugs
    • 292.89 Other
      • Drug-induced organic personality syndrome
  • 292.9 Unspecified drug-induced mental disorder
    • Organic psychosis NOS due to or associated with drugs
• 293 Transient organic psychotic conditions
  • Includes: transient organic mental disorders not associated with alcohol or drugs
  • Use additional code to identify the associated physical or neurological condition
  • Excludes: confusional state or delirium superimposed on senile dementia (290.3)
    • dementia due to:
      • alcohol (291.0-291.9)
      • arteriosclerosis (290.40-290.43)
      • drugs (292.82)
      • senility (290.0)
  • 293.0 Acute delirium
    • Acute:
      • confusional state
      • infective psychosis
      • organic reaction
      • posttraumatic organic psychosis
      • psycho-organic syndrome
    • Acute psychosis associated with endocrine, metabolic, or cerebrovascular disorder
    • Epileptic:
      • confusional state
      • twilight state
  • 293.1 Subacute delirium
    • Subacute:
      • confusional state
      • infective psychosis
      • organic reaction
      • posttraumatic organic psychosis
      • psycho-organic syndrome
      • psychosis associated with endocrine or metabolic disorder
  • 293.8 Other specified transient organic mental disorders
    • 293.81 Organic delusional syndrome
      • Transient organic psychotic condition, paranoid type
    • 293.82 Organic hallucinosis syndrome
      • Transient organic psychotic condition, hallucinatory type
    • 293.83 Organic affective syndrome
      • Transient organic psychotic condition, depressive type
    • 293.89 Other
  • 293.9 Unspecified transient organic mental disorder
    • Organic psychosis:
      • infective NOS
      • posttraumatic NOS
      • transient NOS
    • Psycho-organic syndrome
• 294 Other organic psychotic conditions (chronic)
  • Includes: organic psychotic brain syndromes (chronic), not elsewhere classified
  • 294.0 Amnestic syndrome
    • Korsakoff's psychosis or syndrome (nonalcoholic)
    • Excludes: alcoholic:
      • amnestic syndrome (291.1)
      • Korsakoff's psychosis (291.1)
  • 294.1 Dementia in conditions classified elsewhere
    • :
  • This instructional note is used for those codes not intended to be used as a principal diagnosis, or not to be sequenced before the underlying disease. The note requires that the underlying disease (etiology) be recorded first and the particular manifestation recorded secondarily. This note appears only in the Tabular List.
• Code first any underlying physical condition, as:
  • dementia in:
    • cerebral lipidoses (330.1)
    • epilepsy (345.0-345.9)
    • general paresis [syphilis] (094.1)
    • hepatolenticular degeneration (275.1)
    • Huntington's chorea (333.4)
    • multiple sclerosis (340)
    • polyarteritis nodosa (446.0)
    • syphilis (094.1)
  • Excludes: dementia:
    • arteriosclerotic (290.40-290.43)
    • presenile (290.10-290.13)
    • senile (290.0)
    • epileptic psychosis NOS (294.8)
  • 294.8 Other specified organic brain syndromes (chronic)
    • Epileptic psychosis NOS
    • Mixed paranoid and affective organic psychotic states
    • Use additional code for associated epilepsy (345.0-345.9)
    • Excludes: mild memory disturbances, not amounting to dementia (310.1)
  • 294.9 Unspecified organic brain syndrome (chronic)
    • Organic psychosis (chronic)