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F10.151 ICD-10-CM Code: Alcohol abuse with alcohol-induced psychotic disorder with hallucinations

F10.151 maps to CMS-HCC V28 136. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · HCC coding software

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Code lookupF10.151

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

F10.151

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

Alcohol abuse with alcohol-induced psychotic disorder with hallucinations

A person who abuses alcohol and experiences hallucinations (seeing or hearing things that aren't there) as a direct result of their alcohol use.

Buddy the Bee presenting code insight

Buddy Insight

This code captures alcohol abuse with alcohol-induced psychotic disorder with hallucinations, documenting a psychiatric manifestation directly caused by alcohol use.

CMS-HCC V28

HCC 136

Code-level coefficient reference

CMS-HCC V24

Historical

Historical

Not used for CY2026 payment

ACA/HHS

HCC 083

Code-level coefficient reference

ESRD/PACE

HCC 54

Code-level coefficient reference

RXHCC

N/A

Not mapped

Inclusion Terms

Official

No inclusion terms are included in this display for F10.151. Check the code and parent instructions in the Code Book.

Excludes 2

Official
  • symptoms, signs and abnormal clinical laboratory findings, not elsewhere classified (R00-R99)Inherited from F01-F99

Includes

Official
  • disorders of psychological developmentInherited from F01-F99

Excludes 1

Official
  • alcohol dependence (F10.2-)Inherited from F10.1
  • alcohol use, unspecified (F10.9-)Inherited from F10.1

Code First

Official

No Code First sequencing instructions are included in this display for F10.151. Check the code and parent instructions in the Code Book.

Use Additional

Official
  • code for blood alcohol level, if applicable (Y90.-)Inherited from F10

Code Also

Official

No Code Also instructions are included in this display for F10.151. Check the code and parent instructions in the Code Book.

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 that the psychotic disorder with hallucinations is directly attributable to alcohol use, not a primary/independent psychiatric disorder
Documentation of psychotic symptoms (delusions and/or hallucinations) and their temporal relationship to alcohol use

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 that the psychotic disorder with hallucinations is directly attributable to alcohol use, not a primary/independent psychiatric disorder
Documentation of psychotic symptoms (delusions and/or hallucinations) and their temporal relationship to alcohol use

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 a primary psychiatric disorder separately when the condition is substance-induced — the combination code captures both the substance use and the psychiatric manifestation
Failing to establish the temporal relationship between alcohol use and psychiatric symptoms — substance-induced conditions onset during or shortly after intoxication/withdrawal

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)
F20.x — Schizophrenia spectrum disorders; primary psychotic disorders are independent of substance use — verify temporal relationship to alcohol

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 F10.151 an HCC code?

Yes. F10.151 (Alcohol abuse with alcohol-induced psychotic disorder with hallucinations) maps to HCC 136, Alcohol Use with Psychotic Complications under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.424. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.

Coder answer: F10.151 is billable and maps to V28 HCC 136, Alcohol Use with Psychotic Complications. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code
F10.151
Description
Alcohol abuse with alcohol-induced psychotic disorder with hallucinations
HCC (V28)
HCC 136 — Alcohol Use with Psychotic Complications
RAF reference coefficient
0.424
Billable
Yes
Payment year
2026

HCC Category Mapping

V28HCC 136, Alcohol Use with Psychotic Complications
0.424
ESRDHCC 54, Substance Use with Psychotic Complications
Not separately weighted

These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. 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 context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.

Work F10.151 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for F10.151

For F10.151, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.

  • 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

Coder workflow notes

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What This Code Means

F10.151 is the ICD-10-CM diagnosis code for alcohol abuse with alcohol-induced psychotic disorder with hallucinations. A person who abuses alcohol and experiences hallucinations (seeing or hearing things that aren't there) as a direct result of their alcohol use. F10.151 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 CMS-HCC V28 risk adjustment model, F10.151 maps to Alcohol Use with Psychotic Complications (HCC 136) with a source-labeled community, non-dual, aged reference coefficient of 0.424. No V24 mapping is shown for F10.151; use the applicable model and payment year when reviewing the V28 mapping. For CY2026 non-PACE Medicare Advantage, CMS uses 100% of the 2024 CMS-HCC model (V28). PACE uses a separate model blend. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.

Document the presence of hallucinations specifically in the clinical record to support this more specific code versus F10.159. For F10.151, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule. 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, source-labeled coefficient references, and MEAT documentation criteria for F10.151 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Document the presence of hallucinations specifically in the clinical record to support this more specific code versus F10.159
  • Ensure documentation clearly links the psychotic symptoms to alcohol abuse rather than an independent psychiatric condition

Clinical Significance

This code captures alcohol abuse with alcohol-induced psychotic disorder with hallucinations, documenting a psychiatric manifestation directly caused by alcohol use. The distinction between substance-induced psychiatric symptoms and primary psychiatric disorders is clinically crucial for treatment planning — substance-induced conditions may resolve with sustained sobriety. These combination codes carry higher risk adjustment weight reflecting the dual complexity of substance use disorder combined with psychiatric comorbidity.

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 that the psychotic disorder with hallucinations is directly attributable to alcohol use, not a primary/independent psychiatric disorder
  • Documentation of psychotic symptoms (delusions and/or hallucinations) and their temporal relationship to alcohol use
  • 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)
  • F20.x: Schizophrenia spectrum disorders; primary psychotic disorders are independent of substance use: verify temporal relationship to alcohol

Child Codes

Code Hierarchy

For F10.151, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.

F10.151 maps to CMS-HCC V28 category 136, Alcohol Use with Psychotic Complications. See the ICD-10 to HCC mapping hub for how the V28 crosswalk works. The mapping identifies a payment HCC category for F10.151. Review its source-labeled HCC coefficient above, check the RAF Calculator with complete member context for CMS-HCC V28 PY2026, and confirm the documentation the chart needs before the code is submitted. HCC Buddy shows no RAF score unless every required source and calculation check passes.

Work F10.151 in HCC Buddy

Open F10.151 in the Code Book for the full Index-to-Tabular path, MEAT checklist, and V28 HCC mapping, or in the Encoder to code from a keyword search. Pro includes 7 days to try everything, no card required.