What is ICD-10 code F10.96?

F10.96 is the ICD-10-CM diagnosis code for Alcohol use, unspecified with alcohol-induced persisting amnestic disorder. A long-term memory disorder caused by chronic alcohol use where the person has difficulty forming new memories and may have gaps in past memories. F10.96 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. F10.96 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. F10.96 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. F10.96 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 F10.96?

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 F10.96, 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 F10.96?

This code indicates a persistent condition that continues even after alcohol use stops, distinguishing it from acute alcohol-related confusion Document evidence of memory impairment and its relationship to chronic alcohol consumption in the clinical record Because F10.96 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 F10.96: Alcohol use, unspecified

ICD-10-CM Code View

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Code lookupF10.96Effective 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)

F10.96

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

Alcohol use, unspecified with alcohol-induced persisting amnestic disorder

A long-term memory disorder caused by chronic alcohol use where the person has difficulty forming new memories and may have gaps in past memories.

Buddy Insight

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

F10.9Alcohol use, unspecified

F10.96Alcohol use, unspecified with alcohol-induced persisting amnestic disorder

Inclusion Terms

Official

Alcohol-induced major neurocognitive disorder, amnestic-confabulatory type, without use disorder

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for F10.96 in this effective period.

Related Child Codes

Official

F10.90Alcohol use, unspecified, uncomplicated

F10.91Alcohol use, unspecified, in remission

F10.92Alcohol use, unspecified with intoxication

F10.93Alcohol use, unspecified with withdrawal

F10.94Alcohol use, unspecified with alcohol-induced mood disorder

Includes

Official

ICD-10-CM does not list Includes notes for F10.96 in this effective period.

Excludes 1

Official

alcohol abuse (F10.1-)
alcohol dependence (F10.2-)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for F10.96 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for F10.96 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for F10.96 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Provider diagnosis of alcohol-induced persisting amnestic disorder or Korsakoff syndrome

Documentation of memory impairment (inability to form new memories, gaps in past memories)

Evidence of chronic/heavy alcohol use history

Assessment distinguishing from other dementias or acute confusional states

MEAT Support

HCC Buddy guidance

Provider diagnosis of alcohol-induced persisting amnestic disorder or Korsakoff syndrome

Documentation of memory impairment (inability to form new memories, gaps in past memories)

Evidence of chronic/heavy alcohol use history

Assessment distinguishing from other dementias or acute confusional states

Audit Caution

HCC Buddy guidance

Confusing amnestic disorder (primarily memory) with dementia (global cognitive decline) — these are distinct diagnoses

Coding acute alcohol-related confusion as persisting amnestic disorder — 'persisting' means it continues after alcohol cessation

Failing to distinguish Korsakoff syndrome from Wernicke encephalopathy, which is the acute phase

Using the unspecified use code when abuse or dependence is documented in the record

Common Mistakes

HCC Buddy guidance

F10.97 — Alcohol use, unspecified with alcohol-induced persisting dementia: use when global cognitive decline is present, not just memory impairment

F10.27 — Alcohol dependence with alcohol-induced persisting dementia: use when dependence is documented with dementia

F10.26 — Alcohol dependence with alcohol-induced persisting amnestic disorder: use when dependence is documented

R41.3 — Other amnesia: use when amnesia is NOT alcohol-induced

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 F10.96 an HCC code?

Yes. F10.96 (Alcohol use, unspecified 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: F10.96 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: F10.96
Description: Alcohol use, unspecified 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 F10.96 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for F10.96

For F10.96 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 F10.96 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

F10.96 is the ICD-10-CM diagnosis code for alcohol use, unspecified with alcohol-induced persisting amnestic disorder. A long-term memory disorder caused by chronic alcohol use where the person has difficulty forming new memories and may have gaps in past memories. F10.96 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, F10.96 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, F10.96 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 persistent condition that continues even after alcohol use stops, distinguishing it from acute alcohol-related confusion. Because F10.96 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 F10.96 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•This code indicates a persistent condition that continues even after alcohol use stops, distinguishing it from acute alcohol-related confusion
•Document evidence of memory impairment and its relationship to chronic alcohol consumption in the clinical record

Clinical Significance

Alcohol-induced persisting amnestic disorder (Korsakoff syndrome) is a chronic neurological condition caused by thiamine deficiency from prolonged alcohol use, resulting in severe anterograde amnesia and confabulation. This condition is irreversible in most cases and indicates end-stage alcohol-related brain damage, requiring ongoing supportive care and supervision.

Documentation Requirements

✓Provider diagnosis of alcohol-induced persisting amnestic disorder or Korsakoff syndrome
✓Documentation of memory impairment (inability to form new memories, gaps in past memories)
✓Evidence of chronic/heavy alcohol use history
✓Assessment distinguishing from other dementias or acute confusional states
✓Documentation that the amnesia persists beyond acute intoxication or withdrawal
✓Neuropsychological testing results if available

Commonly Confused Codes

•F10.97: Alcohol use, unspecified with alcohol-induced persisting dementia: use when global cognitive decline is present, not just memory impairment
•F10.27: Alcohol dependence with alcohol-induced persisting dementia: use when dependence is documented with dementia
•F10.26: Alcohol dependence with alcohol-induced persisting amnestic disorder: use when dependence is documented
•R41.3: Other amnesia: use when amnesia is NOT alcohol-induced