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F10.231 ICD-10-CM Code: Alcohol dependence with withdrawal delirium

F10.231 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 Buddy coding tools

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Code lookupF10.231

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

F10.231

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

Alcohol dependence with withdrawal delirium

A person who is dependent on alcohol and is experiencing delirium during alcohol withdrawal, characterized by severe confusion and agitation.

Buddy the Bee presenting code insight

Buddy Insight

This code captures alcohol dependence with withdrawal delirium (delirium tremens), indicating physiological dependence severe enough to produce withdrawal symptoms upon cessation or reduction of alcohol intake.

OverviewRisk ModelsCode BookDocumentationAuditNotesEdition comparison

CMS-HCC V28

HCC 136

Coefficient HCC 136: 0.424 (Community Non-Dual Aged (CNA))

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

Code Book Path

Official
F10.2Alcohol dependenceF10.23Alcohol dependence with withdrawalF10.231Alcohol dependence with withdrawal delirium

Inclusion Terms

Official

No inclusion terms are included in this display for F10.231. 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, F10.2, F10.23
  • toxic effect of alcohol (T51.0-)Inherited from F01-F99, F10.2, F10.23
  • Alcohol dependence with intoxication (F10.22-)Inherited from F01-F99, F10.2, F10.23

Related Codes

Official
F10.230Alcohol dependence with withdrawal, uncomplicatedF10.232Alcohol dependence with withdrawal with perceptual disturbanceF10.239Alcohol dependence with withdrawal, unspecified

Includes

Official
  • disorders of psychological developmentInherited from F01-F99

Excludes 1

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

Code First

Official

No Code First sequencing instructions are included in this display for F10.231. 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 F10.231. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance
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 withdrawal symptoms (tremor, diaphoresis, tachycardia, hypertension, anxiety, nausea, seizures) occurring after reduction or cessation of alcohol use
Documentation of delirium tremens: severe confusion, agitation, hallucinations, autonomic instability, fever — a medical emergency requiring ICU-level care
Assessment and plan addressing alcohol use disorder with treatment recommendations (counseling, medication-assisted treatment, referral, etc.)

MEAT Support

HCC Buddy guidance
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 withdrawal symptoms (tremor, diaphoresis, tachycardia, hypertension, anxiety, nausea, seizures) occurring after reduction or cessation of alcohol use
Documentation of delirium tremens: severe confusion, agitation, hallucinations, autonomic instability, fever — a medical emergency requiring ICU-level care
Assessment and plan addressing alcohol use disorder with treatment recommendations (counseling, medication-assisted treatment, referral, etc.)

Audit Caution

HCC Buddy guidance
Downcoding alcohol dependence to abuse — if the provider documents 'dependence,' code dependence regardless of the current clinical presentation
Assigning an alcohol use disorder code based solely on lab values (elevated GGT, MCV) without provider documentation of the clinical diagnosis
Failing to code withdrawal delirium or perceptual disturbance when documented — these represent higher-acuity complications that should be captured
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
F10.1x — 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.x30 — Withdrawal, uncomplicated; delirium represents a severe complication and should not be coded as uncomplicated withdrawal

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 F10.231 an HCC code?

Yes. F10.231 (Alcohol dependence with withdrawal delirium) 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: F10.231 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
F10.231
Description
Alcohol dependence with withdrawal delirium
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 F10.231 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for F10.231

For F10.231, 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

F10.231 is the ICD-10-CM diagnosis code for alcohol dependence with withdrawal delirium. A person who is dependent on alcohol and is experiencing delirium during alcohol withdrawal, characterized by severe confusion and agitation. F10.231 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, F10.231 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 F10.231; 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.

Alcohol dependence with withdrawal delirium. The provider must document DTs, disorientation, hallucinations, autonomic instability in the setting of alcohol withdrawal, typically requiring inpatient management. For F10.231, 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 F10.231 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • •Alcohol dependence with withdrawal delirium. The provider must document DTs, disorientation, hallucinations, autonomic instability in the setting of alcohol withdrawal, typically requiring inpatient management.
  • •Do not confuse F10.231 (withdrawal delirium) with F10.232 (withdrawal with hallucinations, without full delirium). Delirium requires the disoriented, altered-consciousness pattern.
  • •Withdrawal delirium is among the most clinically severe acute alcohol presentations; narrative should be clear and audit-defensible.

Clinical Significance

This code captures alcohol dependence with withdrawal delirium (delirium tremens), indicating physiological dependence severe enough to produce withdrawal symptoms upon cessation or reduction of alcohol intake. Withdrawal delirium (delirium tremens) is a life-threatening medical emergency with mortality rates of 1-5% even with treatment, requiring intensive monitoring. Withdrawal codes carry significant risk adjustment implications and reflect high-acuity clinical scenarios.

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 withdrawal symptoms (tremor, diaphoresis, tachycardia, hypertension, anxiety, nausea, seizures) occurring after reduction or cessation of alcohol use
  • ✓Documentation of delirium tremens: severe confusion, agitation, hallucinations, autonomic instability, fever — a medical emergency requiring ICU-level care
  • ✓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.x30: Withdrawal, uncomplicated; delirium represents a severe complication and should not be coded as uncomplicated withdrawal

Child Codes

F10.230Alcohol dependence with withdrawal, uncomplicated
HCC 139
F10.231Alcohol dependence with withdrawal delirium
HCC 136
F10.232Alcohol dependence with withdrawal with perceptual disturbance
HCC 136
F10.239Alcohol dependence with withdrawal, unspecified
HCC 139

Code Hierarchy

└F10Alcohol related disorders└F10.2Alcohol dependence└F10.23Alcohol dependence with withdrawal└F10.231Alcohol dependence with withdrawal delirium
└F10.231Alcohol dependence with withdrawal delirium

Also searched as

  • F10 231
  • F10231

For F10.231, 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.

F10.231 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 F10.231. 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.

More on F10.231

Code family

Every F10 code with its CMS-HCC V28 statusAlcohol related disorders, 58 billable codes

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