Substance/Medication-Induced Bipolar and Related Disorder 143
Specify if (see Table 1 in the chapter “Substance-Related and Addictive Disorders” for di-
agnoses associated with substance class):
With onset during intoxication:  If the criteria are met for intoxication with the sub-
stance and the symptoms develop during intoxication.
With onset during withdrawal:  If criteria are met for withdrawal from the substance
and the symptoms develop during, or shortly after, withdrawal.
Recording Procedures
ICD-9-CM. The name of the substance/medication -induced bipolar and related disor-
der begins with the specific su bstance (e.g., cocaine, dexame thasone) that is presumed to
be causing the bipolar mood symptoms. The diag nostic code is selected from the table in-
cluded in the criteria set, which is based on the drug class. For substances that do not fit
into any of the classes (e.g., dexamethason e), the code for “other substance” should be
used; and in cases in which a substance is judged  to be an etiological factor but the specific
class of substance is unknown, the category “unknown substance” should be used.
The name of the disorder is followed by the sp ecification of onset (i.e., onset during in-
toxication, onset during with drawal). Unlike the recording procedures for ICD-10-CM,
which combine the substance-induced disorder and substance use disorder into a single
code, for ICD-9-CM a separate diagnostic code  is given for the substance use disorder. For
example, in the case of irritable symptoms oc curring during intoxica tion in a man with a
severe cocaine use disorder, the diagnosis is 292.84 cocaine-induced bipolar and related