V28 HCC 136
Alcohol Use with Psychotic Complications
Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 136 has a source-labeled community non-dual aged reference coefficient of 0.424, and 19 ICD-10-CM diagnosis codes appear in its official mapping. In the V28 hierarchy it is superseded by HCC 135 when a more severe category in the same disease group is also present.
RAF factors
The community factor varies by Medicaid and originally-disabled status; the institutional factor applies to long-term-institutional members. These are the CMS-HCC V28 PY2026 relative factors.
These are source-labeled code-level HCC coefficient references, not a full member score. Use the RAF Calculator with complete member context for CMS-HCC V28 PY2026. No score is shown unless every required source and calculation check passes.
V28 hierarchy
Trumped by: HCC 135 (a more severe category in the same disease group supersedes this one).
Supersedes: HCC 137, HCC 138, HCC 139 (this category is counted instead of these when they co-occur).
ICD-10-CM codes that map to HCC 136 (19)
ICD-10-CM codes in the official mapping for this category under CMS-HCC V28 PY2026. Open any code for its full description and coding guidance.
- F10.131Alcohol abuse with withdrawal delirium
- F10.132Alcohol abuse with withdrawal with perceptual disturbance
- F10.150Alcohol abuse with alcohol-induced psychotic disorder with delusions
- F10.151Alcohol abuse with alcohol-induced psychotic disorder with hallucinations
- F10.159Alcohol abuse with alcohol-induced psychotic disorder, unspecified
- F10.231Alcohol dependence with withdrawal delirium
- F10.232Alcohol dependence with withdrawal with perceptual disturbance
- F10.250Alcohol dependence with alcohol-induced psychotic disorder with delusions
- F10.251Alcohol dependence with alcohol-induced psychotic disorder with hallucinations
- F10.259Alcohol dependence with alcohol-induced psychotic disorder, unspecified
- F10.26Alcohol dependence with alcohol-induced persisting amnestic disorder
- F10.27Alcohol dependence with alcohol-induced persisting dementia
- F10.931Alcohol use, unspecified with withdrawal delirium
- F10.932Alcohol use, unspecified with withdrawal with perceptual disturbance
- F10.950Alcohol use, unspecified with alcohol-induced psychotic disorder with delusions
- F10.951Alcohol use, unspecified with alcohol-induced psychotic disorder with hallucinations
- F10.959Alcohol use, unspecified with alcohol-induced psychotic disorder, unspecified
- F10.96Alcohol use, unspecified with alcohol-induced persisting amnestic disorder
- F10.97Alcohol use, unspecified with alcohol-induced persisting dementia
Coder workflow notes
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Frequently asked questions
What is CMS-HCC V28 category 136?
HCC 136 is "Alcohol Use with Psychotic Complications", a Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 19 ICD-10-CM codes appear in its official mapping.
What reference coefficient is published for HCC 136?
The source-labeled community non-dual aged reference coefficient for CMS-HCC V28 category 136 is 0.424. The exact coefficient varies by enrollment segment (community Medicaid and originally-disabled status, and institutional); the full segment table is published in the CMS V28 model files.
How many ICD-10-CM codes map to HCC 136?
19 ICD-10-CM diagnosis codes appear in the official mapping for CMS-HCC V28 category 136 (Alcohol Use with Psychotic Complications) for payment year 2026.
Which categories trump HCC 136 in the V28 hierarchy?
HCC 136 is superseded by HCC 135 (Drug Use with Psychotic Complications). When a more severe category in the same disease group is documented, it is counted instead of HCC 136.
Related references
Sources
CMS ICD-10-CM order-file billability plus the published mapping and CMS-HCC V28 PY2026 model software. CMS-HCC V28 model published at CMS.gov Risk Adjustors; ICD-10-CM member codes from the CMS ICD-10-CM code set.
Verified current to CMS-HCC V28, payment year 2026 — last reviewed May 30, 2026.