F10.21 ICD-10-CM Code: Alcohol dependence, in remission

Code

F10.21

Description

Alcohol dependence, in remission

HCC (V28)

HCC 139 — Alcohol Use Disorder, Moderate/Severe, or Alcohol Use with Specified Non-Psychotic Complications

RAF

0.242

Billable

Yes

Payment year

2026

HCC Category Mapping

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 F10.21 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for F10.21

What This Code Means

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for F10.21 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

• •Alcohol dependence, in remission. Documentation must establish historical dependence plus current sustained remission, the provider typically notes months or years sober and continuing monitoring.
• •F10.21 still risk-adjusts, do not drop the code when the patient is in remission. Coders sometimes omit remission codes thinking they describe resolved disease, but the HCC captures the ongoing dependence diagnosis.
• •V28 HCC 139 (Alcohol Use Disorder, Moderate/Severe, or Alcohol Use with Specified Non-Psychotic Complications) at RAF 0.242, the same HCC as active uncomplicated dependence. Alcohol dependence in remission still maps; the in-remission status is documentation-relevant but does not zero out the HCC.

Clinical Significance

This code captures alcohol dependence currently in remission, documenting a history of alcohol dependence where the patient is not actively using or meeting criteria for active dependence. Remission status is important for ongoing monitoring, relapse prevention planning, and medication management. This code still carries risk adjustment weight because patients in remission require continued care coordination and monitoring.

Documentation Requirements

• ✓Documentation of alcohol dependence with at least three of: tolerance, withdrawal, use in larger amounts/longer periods than intended, persistent desire or unsuccessful efforts to cut down, significant time spent obtaining/using/recovering, important activities given up, continued use despite knowledge of physical/psychological problems
• ✓Documentation of remission status — specify early remission (3-12 months) or sustained remission (12+ months) if possible
• ✓Assessment and plan addressing alcohol use disorder with treatment recommendations (counseling, medication-assisted treatment, referral, etc.)

Commonly Confused Codes

• •F10.1x: Alcohol abuse codes; abuse is a less severe pattern: if documentation says 'dependence,' do not downcode to abuse
• •F10.9x: Alcohol use, unspecified; always code dependence when documented, as it carries appropriate risk adjustment weight
• •F10.20: Alcohol dependence, uncomplicated; use F10.21 specifically when remission is documented
• •Z87.891: Personal history of nicotine dependence; not the same pattern: alcohol remission uses the active code with remission qualifier

Child Codes