F10.97 ICD-10-CM Code: Alcohol use, unspecified with alcohol-induced persisting dementia
F10.97 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 coding software
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FY 2026 Apr update / Mental, Behavioral and Neurodevelopmental disorders (F01-F99) / Mental and behavioral disorders due to psychoactive substance use (F10-F19)
F10.97
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceAlcohol use, unspecified with alcohol-induced persisting dementia
Progressive brain damage and cognitive decline caused by long-term heavy alcohol use, resulting in memory loss, confusion, and difficulty with daily functioning.
Buddy Insight
Alcohol-induced persisting dementia represents progressive, irreversible cognitive deterioration caused by chronic heavy alcohol use, affecting memory, executive function, judgment, and daily living skills.
CMS-HCC V28
MappedHCC 136
Coefficient HCC 136: 0.424 (Community Non-Dual Aged (CNA))
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
MappedHCC 083
Code-level coefficient reference
ESRD/PACE
MappedHCC 54
Code-level coefficient reference
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
Official- Alcohol-induced major neurocognitive disorder, nonamnestic-confabulatory type, without use disorder
Excludes 2
Official- symptoms, signs and abnormal clinical laboratory findings, not elsewhere classified (R00-R99)Inherited from F01-F99
Related Codes
Includes
Official- disorders of psychological developmentInherited from F01-F99
Excludes 1
Official- alcohol abuse (F10.1-)Inherited from F10.9
- alcohol dependence (F10.2-)Inherited from F10.9
Code First
OfficialNo Code First sequencing instructions are included in this display for F10.97. 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
OfficialNo Code Also instructions are included in this display for F10.97. Check the code and parent instructions in the Code Book.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
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 F10.97 an HCC code?
Yes. F10.97 (Alcohol use, unspecified with alcohol-induced persisting dementia) 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: F10.97 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
- F10.97
- Description
- Alcohol use, unspecified with alcohol-induced persisting dementia
- HCC (V28)
- HCC 136 — Alcohol Use with Psychotic Complications
- RAF reference coefficient
- 0.424
- 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 F10.97 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT review for F10.97
For F10.97, 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
F10.97 is the ICD-10-CM diagnosis code for alcohol use, unspecified with alcohol-induced persisting dementia. Progressive brain damage and cognitive decline caused by long-term heavy alcohol use, resulting in memory loss, confusion, and difficulty with daily functioning. F10.97 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, F10.97 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 F10.97; 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.
Ensure documentation distinguishes alcohol-induced dementia from other types of dementia or age-related cognitive decline. For F10.97, 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 F10.97 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Ensure documentation distinguishes alcohol-induced dementia from other types of dementia or age-related cognitive decline
- •Code the severity level if documented, and consider coding any associated behavioral or psychiatric symptoms separately
Clinical Significance
Alcohol-induced persisting dementia represents progressive, irreversible cognitive deterioration caused by chronic heavy alcohol use, affecting memory, executive function, judgment, and daily living skills. This is among the most severe complications of alcohol use and indicates a high level of ongoing care needs including possible long-term care placement.
Documentation Requirements
- ✓Provider diagnosis of alcohol-induced persisting dementia
- ✓Documentation of global cognitive decline (not just memory — must include impaired judgment, executive dysfunction, personality changes)
- ✓History of chronic heavy alcohol use establishing causal relationship
- ✓Cognitive assessment or neuropsychological testing results
- ✓Documentation that dementia persists after alcohol cessation
- ✓Functional status assessment and level of care needed
- ✓Assessment ruling out other dementia etiologies (Alzheimer disease, vascular, Lewy body)
Commonly Confused Codes
- •F10.96: Alcohol use, unspecified with persisting amnestic disorder: use when impairment is limited to memory without global cognitive decline
- •F10.27: Alcohol dependence with persisting dementia: use when dependence is established
- •G31.2: Degeneration of nervous system due to alcohol: use for neurological degeneration without dementia
- •F03.90: Unspecified dementia without behavioral disturbance: use when dementia is NOT alcohol-induced