F12.120
BillableCannabis abuse with intoxication, uncomplicated
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F12.120 an HCC code?
Yes. F12.120 maps to Drug/Alcohol Dependence under the V24 model but is not retained in V28.
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 F12.120
For F12.120 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 F12.120 during that encounter — not just copy-forwarded from a problem list.
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).
Under the older CMS-HCC V24 model, F12.120 maps to Drug/Alcohol Dependence (HCC 55) with a community, non-dual, aged base RAF weight of 0.334. 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.
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. Because F12.120 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 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