F10.950
BillableAlcohol use, unspecified with alcohol-induced psychotic disorder with delusions
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F10.950 an HCC code?
Yes. F10.950 maps to Alcohol Use with Psychotic Complications under the CMS-HCC V28 risk adjustment model (and Drug/Alcohol Psychosis 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 F10.950
For F10.950 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 F10.950 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F10.950 is the ICD-10-CM diagnosis code for alcohol use, unspecified with alcohol-induced psychotic disorder with delusions. A serious mental condition where alcohol use causes psychotic symptoms, specifically false beliefs or delusions that feel completely real to the person. F10.950 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, F10.950 maps to Alcohol Use with Psychotic Complications (HCC 136) with a community, non-dual, aged base RAF weight of 0.275. Under the older CMS-HCC V24 model, F10.950 maps to Drug/Alcohol Psychosis (HCC 54) with a community, non-dual, aged base RAF weight of 0.434. 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.
Document the specific delusions present and their temporal relationship to alcohol consumption. Because F10.950 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 F10.950 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document the specific delusions present and their temporal relationship to alcohol consumption
- •Distinguish between alcohol-induced psychosis and primary psychotic disorders by confirming symptoms emerge during or shortly after alcohol use
Clinical Significance
Alcohol-induced psychotic disorder with delusions represents a severe psychiatric complication where alcohol consumption causes fixed false beliefs. This condition requires urgent psychiatric evaluation and indicates significant neurological impact from alcohol use. It carries higher clinical resource utilization than non-psychotic alcohol disorders.
Documentation Requirements
- ✓Provider documentation of specific delusions (paranoid, grandiose, persecutory, etc.)
- ✓Temporal relationship establishing delusions emerged during or shortly after alcohol use
- ✓Clinical assessment ruling out primary psychotic disorders (schizophrenia, schizoaffective disorder)
- ✓Documentation of alcohol use pattern
- ✓Mental status examination findings supporting psychotic features
- ✓Treatment plan addressing both psychosis and alcohol use