F10.181
BillableAlcohol abuse with alcohol-induced sexual dysfunction
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F10.181 an HCC code?
Yes. F10.181 maps to Alcohol Use Disorder under the CMS-HCC V28 risk adjustment model (and Drug/Alcohol Dependence under V24).
HCC Category Mapping
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. 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.
MEAT Criteria for F10.181
For F10.181 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 F10.181 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F10.181 is the ICD-10-CM diagnosis code for alcohol abuse with alcohol-induced sexual dysfunction. A person who abuses alcohol and experiences sexual dysfunction (such as erectile dysfunction or decreased sexual desire) as a result of their alcohol use. F10.181 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, F10.181 maps to Alcohol Use Disorder (HCC 139) with a community, non-dual, aged base RAF weight of 0.584. Under the older CMS-HCC V24 model, F10.181 maps to Drug/Alcohol Dependence (HCC 55) with a community, non-dual, aged base RAF weight of 0.334. 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.
Ensure documentation specifies the type of sexual dysfunction if possible for more complete clinical records. Because F10.181 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 F10.181 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Ensure documentation specifies the type of sexual dysfunction if possible for more complete clinical records
- •Verify that the sexual dysfunction is alcohol-induced rather than due to other medical or psychological causes
Clinical Significance
This code captures alcohol abuse with alcohol-induced sexual dysfunction, reflecting the clinical complexity of alcohol use disorders and their systemic effects. Proper classification of the use level and associated complications is essential for treatment planning and resource allocation. Risk adjustment models recognize the significant healthcare utilization associated with alcohol use disorders and their complications.
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)
- ✓Assessment and plan addressing alcohol use disorder with treatment recommendations (counseling, medication-assisted treatment, referral, etc.)