What is ICD-10 code F10.26?

F10.26 is the ICD-10-CM diagnosis code for Alcohol dependence with alcohol-induced persisting amnestic disorder. A person who is dependent on alcohol and has developed a lasting memory disorder (Wernicke-Korsakoff syndrome) caused by chronic alcohol use. F10.26 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. F10.26 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. F10.26 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. F10.26 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

What is the V28 vs V24 difference for F10.26?

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. For F10.26, V28 maps to Alcohol Use with Psychotic Complications at RAF 0.424 while V24 mapped to Substance Use with Psychotic Complications at RAF 0.329. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting F10.26?

This code indicates a chronic, persisting condition rather than acute intoxication or withdrawal effects Document evidence of memory impairment and its relationship to alcohol dependence Because F10.26 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score.

2026 ICD-10-CM F10.26: Alcohol dependence

ICD-10-CM Code View

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Code lookupF10.26Effective periodFY2026 Apr Update (Apr 1-Sep 30)

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

F10.26

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

Alcohol dependence with alcohol-induced persisting amnestic disorder

A person who is dependent on alcohol and has developed a lasting memory disorder (Wernicke-Korsakoff syndrome) caused by chronic alcohol use.

Buddy Insight

This code captures alcohol dependence with alcohol-induced persisting amnestic disorder, documenting a psychiatric manifestation directly caused by alcohol use.

CMS-HCC V28

Mapped

HCC 136

Alcohol Use with Psychotic Co...

RAF 0.424

CMS-HCC V24

Mapped

HCC 54

Substance Use with Psychotic ...

RAF 0.329

ACA/HHS

Mapped

HCC 83

HHS-HCC 83

Varies by metal level

ESRD/PACE

Mapped

HCC 54

Substance Use with Psychotic ...

RAF 0.111

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

F10Alcohol related disorders

F10.2Alcohol dependence

F10.26Alcohol dependence with alcohol-induced persisting amnestic disorder

Inclusion Terms

Official

Alcohol use disorder, moderate, with alcohol-induced major neurocognitive disorder, amnestic-confabulatory type
Alcohol use disorder, severe, with alcohol-induced major neurocognitive disorder, amnestic-confabulatory type

Excludes 2

Official

toxic effect of alcohol (T51.0-)

Related Child Codes

Official

F10.20Alcohol dependence, uncomplicated

F10.21Alcohol dependence, in remission

F10.22Alcohol dependence with intoxication

F10.23Alcohol dependence with withdrawal

F10.24Alcohol dependence with alcohol-induced mood disorder

Includes

Official

ICD-10-CM does not list Includes notes for F10.26 in this effective period.

Excludes 1

Official

alcohol abuse (F10.1-)
alcohol use, unspecified (F10.9-)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for F10.26 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for F10.26 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for F10.26 in this effective period.

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 that the persisting amnestic disorder is directly attributable to alcohol use, not a primary/independent psychiatric disorder

Documentation of persistent memory impairment (Korsakoff syndrome) with confabulation, caused by chronic alcohol use and thiamine deficiency

Assessment and plan addressing alcohol use disorder with treatment recommendations (counseling, medication-assisted treatment, referral, etc.)

MEAT Support

HCC Buddy guidance

Documentation that the persisting amnestic disorder is directly attributable to alcohol use, not a primary/independent psychiatric disorder

Documentation of persistent memory impairment (Korsakoff syndrome) with confabulation, caused by chronic alcohol use and thiamine deficiency

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

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

F10.1x — 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

F04 — Amnestic disorder due to known physiological condition; use F10.26 specifically when alcohol is the cause

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 F10.26 an HCC code?

Yes. F10.26 (Alcohol dependence with alcohol-induced persisting amnestic disorder) maps to Alcohol Use with Psychotic Complications under the CMS-HCC V28 risk adjustment model (and Substance Use with Psychotic Complications under V24), with a community non-dual aged RAF of 0.424. It is billable for payment year 2026.

Coder answer: F10.26 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: F10.26
Description: Alcohol dependence with alcohol-induced persisting amnestic disorder
HCC (V28): HCC 136 — Alcohol Use with Psychotic Complications
RAF: 0.424
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 136, Alcohol Use with Psychotic Complications

0.424

V24HCC 54, Substance Use with Psychotic Complications

0.329

ESRDHCC 54, Substance Use with Psychotic Complications

0.111

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 F10.26 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for F10.26

For F10.26 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 F10.26 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

F10.26 is the ICD-10-CM diagnosis code for alcohol dependence with alcohol-induced persisting amnestic disorder. A person who is dependent on alcohol and has developed a lasting memory disorder (Wernicke-Korsakoff syndrome) caused by chronic alcohol use. F10.26 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, F10.26 maps to Alcohol Use with Psychotic Complications (HCC 136) with a community, non-dual, aged base RAF weight of 0.424. Under the older CMS-HCC V24 model, F10.26 maps to Substance Use with Psychotic Complications (HCC 54) with a community, non-dual, aged base RAF weight of 0.329. 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.

This code indicates a chronic, persisting condition rather than acute intoxication or withdrawal effects. Because F10.26 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 F10.26 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•This code indicates a chronic, persisting condition rather than acute intoxication or withdrawal effects
•Document evidence of memory impairment and its relationship to alcohol dependence

Clinical Significance

This code captures alcohol dependence with alcohol-induced persisting amnestic disorder, 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 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 that the persisting amnestic disorder is directly attributable to alcohol use, not a primary/independent psychiatric disorder
✓Documentation of persistent memory impairment (Korsakoff syndrome) with confabulation, caused by chronic alcohol use and thiamine deficiency
✓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
•F04: Amnestic disorder due to known physiological condition; use F10.26 specifically when alcohol is the cause