F10.221
BillableAlcohol dependence with intoxication delirium
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F10.221 an HCC code?
Yes. F10.221 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 F10.221
For F10.221 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 F10.221 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F10.221 is the ICD-10-CM diagnosis code for alcohol dependence with intoxication delirium. A person who is dependent on alcohol and is experiencing delirium (severe confusion and hallucinations) while intoxicated. F10.221 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, F10.221 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, F10.221 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.
Delirium is a serious acute mental state requiring documentation of both the alcohol dependence and the delirium presentation. Because F10.221 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 F10.221 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Delirium is a serious acute mental state requiring documentation of both the alcohol dependence and the delirium presentation
- •Ensure documentation clearly distinguishes delirium from other alcohol-induced conditions like withdrawal or dementia
Clinical Significance
This code captures alcohol dependence with intoxication delirium, documenting an acute episode of alcohol intoxication in a patient with an established pattern of alcohol dependence. Intoxication delirium represents a more severe presentation with altered consciousness and cognitive disturbance requiring urgent medical attention. Accurate coding of the use level (dependence) and intoxication status is critical for tracking substance use severity and ensuring appropriate risk adjustment.
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 acute intoxication at the time of the encounter, with clinical findings (e.g., blood alcohol level, slurred speech, impaired coordination)
- ✓Documentation of delirium symptoms: acute onset of confusion, altered consciousness, disorientation, agitation, or perceptual disturbances during intoxication
- ✓Assessment and plan addressing alcohol use disorder with treatment recommendations (counseling, medication-assisted treatment, referral, etc.)