F12.120 ICD-10-CM Code: Cannabis abuse with intoxication, uncomplicated
F12.120 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · free HCC coding tools
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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)
F12.120
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceCannabis abuse with intoxication, uncomplicated
This code describes a patient who is abusing cannabis (marijuana) and is currently intoxicated from it, without any complications like accidents or injuries. It indicates problematic use of cannabis that has led to the person being under the influence.
Buddy Insight
Cannabis abuse with uncomplicated intoxication identifies patients presenting with acute cannabis intoxication effects in the context of a documented cannabis use disorder at the abuse level.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
MappedHCC 082
Code-level coefficient reference
ESRD/PACE
MappedHCC 55
Code-level coefficient reference
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialNo inclusion terms are included in this display for F12.120. Check the code and parent instructions in the Code Book.
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, F12
- marijuanaInherited from F01-F99, F12
Excludes 1
Official- cannabis dependence (F12.2-)Inherited from F12.1
- cannabis use, unspecified (F12.9-)Inherited from F12.1
Code First
OfficialNo Code First sequencing instructions are included in this display for F12.120. Check the code and parent instructions in the Code Book.
Use Additional
OfficialNo Use Additional Code instructions are included in this display for F12.120. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for F12.120. 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 F12.120 an HCC code?
F12.120 has no mapping under the current CMS-HCC V28 community payment model. F12.120 has a separate mapping under the CMS-HCC ESRD model (HCC 55 (Substance Use Disorder/Moderate/Severe/Substance Use with Complications)); the applicable result needs member context. F12.120 also appears in the HHS-HCC commercial risk model (HCC 082 (HHS-HCC 082 adult, RAF varies by metal level)), which is a commercial market model rather than a Medicare Advantage payment mapping.
- Code
- F12.120
- Description
- Cannabis abuse 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 F12.120 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT review for F12.120
For F12.120, 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
F12.120 is the ICD-10-CM diagnosis code for cannabis abuse with intoxication, uncomplicated. This code describes a patient who is abusing cannabis (marijuana) and is currently intoxicated from it, without any complications like accidents or injuries. It indicates problematic use of cannabis that has led to the person being under the influence. F12.120 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).
F12.120 has no mapping under the current CMS-HCC V28 community payment model. F12.120 has a separate mapping under the CMS-HCC ESRD model (HCC 55 (Substance Use Disorder/Moderate/Severe/Substance Use with Complications)); the applicable result needs member context. F12.120 also appears in the HHS-HCC commercial risk model (HCC 082 (HHS-HCC 082 adult, RAF varies by metal level)), which is a commercial market model rather than a Medicare Advantage payment mapping. Do not assign V28 risk adjustment value from this page; verify the applicable model and payment year before using this code for risk adjustment.
Use this code only when cannabis intoxication is present without complications; if there are accidents, injuries, or other complications, use a more specific code like F12.121 or F12.122.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for F12.120 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code only when cannabis intoxication is present without complications; if there are accidents, injuries, or other complications, use a more specific code like F12.121 or F12.122
- •Ensure documentation clearly distinguishes between cannabis abuse (F12.1x) and cannabis dependence (F12.2x), as these are separate diagnostic categories with different treatment implications
Clinical Significance
Cannabis abuse with uncomplicated intoxication identifies patients presenting with acute cannabis intoxication effects in the context of a documented cannabis use disorder at the abuse level. This diagnosis is clinically relevant because it indicates a pattern of problematic use leading to healthcare encounters during active intoxication. For risk adjustment, cannabis abuse codes capture the resource utilization associated with substance use disorders.
Documentation Requirements
- ✓Documentation of cannabis abuse meeting clinical criteria (maladaptive pattern of use)
- ✓Evidence of current intoxication at the time of encounter
- ✓Description of intoxication symptoms (euphoria, impaired coordination, impaired judgment, etc.)
- ✓Confirmation that intoxication is uncomplicated — no delirium or perceptual disturbances
- ✓Distinction from cannabis dependence with documentation of why abuse vs. dependence is assigned
Commonly Confused Codes
- •F12.121: Cannabis abuse with intoxication delirium; use when delirium accompanies intoxication
- •F12.122: Cannabis abuse with intoxication with perceptual disturbance; use when hallucinations or perceptual changes occur
- •F12.220: Cannabis dependence with intoxication, uncomplicated; use when dependence (not abuse) is documented
- •F12.920: Cannabis use, unspecified with intoxication, uncomplicated; use when the severity of the use disorder is unspecified