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F10.120 ICD-10-CM Code: Alcohol abuse with intoxication, uncomplicated

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FY 2026 Apr update / Mental, Behavioral and Neurodevelopmental disorders (F01-F99) / Mental and behavioral disorders due to psychoactive substance use (F10-F19)

F10.120

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Alcohol abuse with intoxication, uncomplicated

This code describes a patient who misuses alcohol and is currently in a state of intoxication without any serious complications like seizures or delirium. It indicates problematic drinking behavior that has led to being under the influence of alcohol.

Buddy the Bee presenting code insight

Buddy Insight

This code captures alcohol abuse with uncomplicated intoxication, documenting an acute episode of alcohol intoxication in a patient with an established pattern of alcohol abuse.

CMS-HCC V28

N/A

—

Not mapped

CMS-HCC V24

HCC 55

RAF 0.329

ACA/HHS

N/A

—

Not mapped

ESRD/PACE

HCC 55

RAF 0.111

RXHCC

N/A

—

Not mapped

Code Book Path

Official
F10.1Alcohol abuse
F10.12Alcohol abuse with intoxication
F10.120Alcohol abuse with intoxication, uncomplicated

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for F10.120 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for F10.120 in this effective period.

Related Child Codes

Official
F10.121Alcohol abuse with intoxication delirium
F10.129Alcohol abuse with intoxication, unspecified

Includes

Official

ICD-10-CM does not list Includes notes for F10.120 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for F10.120 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for F10.120 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for F10.120 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for F10.120 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Documentation of a maladaptive pattern of alcohol use with clinically significant impairment or distress (recurrent use causing role failure, hazardous use, legal problems, or social/interpersonal problems)
Confirmation that criteria for alcohol dependence are NOT met (no tolerance, withdrawal, or compulsive use pattern)
Documentation of acute intoxication at the time of the encounter, with clinical findings (e.g., blood alcohol level, slurred speech, impaired coordination)
Assessment and plan addressing alcohol use disorder with treatment recommendations (counseling, medication-assisted treatment, referral, etc.)

MEAT Support

HCC Buddy guidance
Documentation of a maladaptive pattern of alcohol use with clinically significant impairment or distress (recurrent use causing role failure, hazardous use, legal problems, or social/interpersonal problems)
Confirmation that criteria for alcohol dependence are NOT met (no tolerance, withdrawal, or compulsive use pattern)
Documentation of acute intoxication at the time of the encounter, with clinical findings (e.g., blood alcohol level, slurred speech, impaired coordination)
Assessment and plan addressing alcohol use disorder with treatment recommendations (counseling, medication-assisted treatment, referral, etc.)

Audit Caution

HCC Buddy guidance
Coding alcohol abuse when documentation actually supports dependence (tolerance, withdrawal, compulsive use) — always use the highest severity level documented
Assigning an alcohol use disorder code based solely on lab values (elevated GGT, MCV) without provider documentation of the clinical diagnosis
Coding intoxication at every encounter — intoxication codes are for episodes of acute intoxication, not for ongoing alcohol use disorder management
Not capturing alcohol use disorder at all when it is documented in the medical record — active conditions affecting care must be coded regardless of the primary reason for the visit

Common Mistakes

HCC Buddy guidance
F10.2x — Alcohol dependence codes; dependence is a more severe pattern with tolerance/withdrawal/compulsive use — verify provider intent
F10.9x — Alcohol use, unspecified; less specific — always code to the highest documented specificity (abuse > unspecified)
F10.220-F10.229 — Alcohol dependence with intoxication; check whether the patient meets criteria for dependence vs. abuse

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is F10.120 an HCC code?

Yes. F10.120 maps to Substance Use Disorder, Moderate/Severe, or Substance Use with Complications under the V24 model but is not retained in V28.

Code
F10.120
Description
Alcohol abuse with intoxication, uncomplicated
HCC (V28)
No CMS-HCC V28 mapping
RAF
—
Billable
Yes
Payment year
2026

HCC Category Mapping

V24HCC 55, Substance Use Disorder, Moderate/Severe, or Substance Use with Complications
0.329
ESRDHCC 55, Substance Use Disorder, Moderate/Severe, or Substance Use with Complications
0.111

Each model's RAF is its CMS base weight for that model's standard population, so weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.

Work F10.120 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for F10.120

For F10.120 to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.

  • MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
  • EEvaluate: test results, medication response, or physical findings reviewed by the provider
  • AAssess: explicit mention in the assessment or plan with acknowledgment of status
  • TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis

Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed F10.120 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

F10.120 is the ICD-10-CM diagnosis code for alcohol abuse with intoxication, uncomplicated. This code describes a patient who misuses alcohol and is currently in a state of intoxication without any serious complications like seizures or delirium. It indicates problematic drinking behavior that has led to being under the influence of alcohol. F10.120 sits in the ICD-10-CM chapter for mental, behavioral and neurodevelopmental disorders (f01-f99), within the section covering mental and behavioral disorders due to psychoactive substance use (f10-f19).

Under the older CMS-HCC V24 model, F10.120 maps to Substance Use Disorder, Moderate/Severe, or Substance Use with Complications (HCC 55) with a community, non-dual, aged base RAF weight of 0.329. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.

Verify documentation clearly states 'alcohol abuse' (not dependence) and 'intoxication' to distinguish from F10.020 (alcohol dependence with intoxication). Because F10.120 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for F10.120 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • •Verify documentation clearly states 'alcohol abuse' (not dependence) and 'intoxication' to distinguish from F10.020 (alcohol dependence with intoxication)
  • •Ensure the intoxication is documented as 'uncomplicated' - if seizures, delirium, or other complications are present, use a different 5th character code (F10.121, F10.129, etc.)

Clinical Significance

This code captures alcohol abuse with uncomplicated intoxication, documenting an acute episode of alcohol intoxication in a patient with an established pattern of alcohol abuse. Accurate coding of the use level (abuse) and intoxication status is critical for tracking substance use severity and ensuring appropriate risk adjustment.

Documentation Requirements

  • ✓Documentation of a maladaptive pattern of alcohol use with clinically significant impairment or distress (recurrent use causing role failure, hazardous use, legal problems, or social/interpersonal problems)
  • ✓Confirmation that criteria for alcohol dependence are NOT met (no tolerance, withdrawal, or compulsive use pattern)
  • ✓Documentation of acute intoxication at the time of the encounter, with clinical findings (e.g., blood alcohol level, slurred speech, impaired coordination)
  • ✓Assessment and plan addressing alcohol use disorder with treatment recommendations (counseling, medication-assisted treatment, referral, etc.)

Commonly Confused Codes

  • •F10.2x: Alcohol dependence codes; dependence is a more severe pattern with tolerance/withdrawal/compulsive use: verify provider intent
  • •F10.9x: Alcohol use, unspecified; less specific: always code to the highest documented specificity (abuse > unspecified)
  • •F10.220-F10.229: Alcohol dependence with intoxication; check whether the patient meets criteria for dependence vs. abuse

Child Codes

F10.120Alcohol abuse with intoxication, uncomplicated
F10.121Alcohol abuse with intoxication delirium
F10.129Alcohol abuse with intoxication, unspecified

Code Hierarchy

└F10Alcohol related disorders└F10.1Alcohol abuse└F10.12Alcohol abuse with intoxication└F10.120Alcohol abuse with intoxication, uncomplicated
└F10.120Alcohol abuse with intoxication, uncomplicated

Because F10.120 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score.

Work F10.120 in HCC Buddy

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