F12.122 ICD-10-CM Code: Cannabis abuse with intoxication with perceptual disturbance
F12.122 is not a CMS-HCC payment code. 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)
F12.122
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceCannabis abuse with intoxication with perceptual disturbance
A person is abusing cannabis and is experiencing perceptual disturbances (such as seeing or hearing things that aren't there) while intoxicated.
Buddy Insight
Cannabis abuse with intoxication with perceptual disturbance identifies patients experiencing hallucinations, illusions, or depersonalization during acute cannabis intoxication.
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 F12.122. 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 F12.122. Check the code and parent instructions in the Code Book.
Use Additional
OfficialNo Use Additional Code instructions are included in this display for F12.122. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for F12.122. 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 F12.122 an HCC code?
F12.122 is not in the CMS-HCC V28 or V24 community payment model. F12.122 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. F12.122 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
- F12.122
- Description
- Cannabis abuse with intoxication with perceptual disturbance
- 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 F12.122 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT review for F12.122
For F12.122, 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
F12.122 is the ICD-10-CM diagnosis code for cannabis abuse with intoxication with perceptual disturbance. A person is abusing cannabis and is experiencing perceptual disturbances (such as seeing or hearing things that aren't there) while intoxicated. F12.122 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).
F12.122 has no mapping under the CMS-HCC V28 or V24 community payment models. F12.122 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. F12.122 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.
Perceptual disturbances must be documented as occurring during cannabis intoxication, not as a separate psychotic disorder.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for F12.122 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
Clinical Significance
Cannabis abuse with intoxication with perceptual disturbance identifies patients experiencing hallucinations, illusions, or depersonalization during acute cannabis intoxication. This is distinct from cannabis-induced psychotic disorder in that the perceptual disturbances occur only during intoxication and the patient maintains awareness that the experiences are substance-related. Documenting perceptual disturbances is clinically important for monitoring progression to more severe psychiatric complications.
Documentation Requirements
- ✓Documentation of cannabis abuse pattern
- ✓Description of specific perceptual disturbances (visual hallucinations, auditory distortions, depersonalization, derealization)
- ✓Temporal link confirming disturbances occur during active cannabis intoxication
- ✓Confirmation that the patient maintains reality testing (distinguishing from psychotic disorder)
- ✓Intact consciousness and orientation (distinguishing from delirium)
Commonly Confused Codes
- •F12.120: Cannabis abuse with intoxication, uncomplicated; use when no perceptual disturbances are present
- •F12.121: Cannabis abuse with intoxication delirium; use when confusion and altered consciousness occur
- •F12.150: Cannabis abuse with psychotic disorder with delusions; use when psychosis persists beyond intoxication and delusions are present
- •F12.151: Cannabis abuse with psychotic disorder with hallucinations; use when hallucinations persist beyond intoxication period