F10.920 ICD-10-CM Code: Alcohol use, unspecified with intoxication, uncomplicated

Code

F10.920

Description

Alcohol use, unspecified with intoxication, uncomplicated

HCC (V28)

No CMS-HCC V28 mapping

RAF reference coefficient

—

Billable

Yes

Payment year

2026

HCC Category Mapping

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 F10.920 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for F10.920

What This Code Means

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for F10.920 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

• •This code indicates acute intoxication without delirium or perceptual disturbances
• •Verify documentation does not indicate delirium or hallucinations, which would require F10.921 or F10.929

Clinical Significance

This code captures alcohol unspecified use with uncomplicated intoxication, documenting an acute episode of alcohol intoxication in a patient with an established pattern of alcohol unspecified use. Accurate coding of the use level (unspecified use) and intoxication status is critical for tracking substance use severity and ensuring appropriate risk adjustment.

Documentation Requirements

• ✓Documentation of alcohol use — query the provider to specify abuse or dependence for more accurate coding when possible
• ✓Documentation of acute intoxication at the time of the encounter, with clinical findings (e.g., blood alcohol level, slurred speech, impaired coordination)
• ✓Assessment and plan addressing alcohol use disorder with treatment recommendations (counseling, medication-assisted treatment, referral, etc.)

Commonly Confused Codes

• •F10.1x: Alcohol abuse; if documentation supports abuse, code abuse instead of unspecified use
• •F10.2x: Alcohol dependence; if documentation supports dependence, code dependence instead of unspecified use
• •Z72.89: Other problems related to lifestyle (includes social drinking); use for non-problematic alcohol use without a disorder

Child Codes