What is ICD-10 code F12.19?

F12.19 is the ICD-10-CM diagnosis code for Cannabis abuse with unspecified cannabis-induced disorder. A person who abuses cannabis and has developed a cannabis-related health problem, but the specific type of problem is not documented or identified. F12.19 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. F12.19 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. F12.19 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. F12.19 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 F12.19?

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. F12.19 was a payment HCC under V24 (Drug/Alcohol Dependence) but the V28 recalibration removed it from the risk adjustment model. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting F12.19?

Use this code only when the specific cannabis-induced disorder cannot be determined from documentation Query the provider if additional details about the induced disorder are available to allow for more specific coding Because F12.19 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.

F12.19 ICD-10 Code: Cannabis abuse

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupF12.19Effective 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)

F12.19

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

Cannabis abuse with unspecified cannabis-induced disorder

A person who abuses cannabis and has developed a cannabis-related health problem, but the specific type of problem is not documented or identified.

Buddy Insight

Cannabis abuse with unspecified cannabis-induced disorder represents the least specific code for cannabis abuse with an induced complication.

CMS-HCC V28

Not risk-adjusted for this model/period.

RAF 0

CMS-HCC V24

Mapped

HCC 55

Drug/Alcohol Dependence

RAF 0.334

ACA/HHS

Not risk-adjusted for this model/period.

RAF 0

ESRD/PACE

Mapped

HCC 55

Drug/Alcohol Dependence

RAF 0.0

RXHCC

Not risk-adjusted for this model/period.

RAF 0

Code Trumping

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Compare selected patient codes to show trumped or trumps impact.

Code Book Path

Official

F12Cannabis related disorders

F12.1Cannabis abuse

F12.19Cannabis abuse with unspecified cannabis-induced disorder

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for F12.19 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for F12.19 in this effective period.

Related Child Codes

Official

F12.10Cannabis abuse, uncomplicated

F12.11Cannabis abuse, in remission

F12.12Cannabis abuse with intoxication

F12.13Cannabis abuse with withdrawal

F12.15Cannabis abuse with psychotic disorder

Includes

Official

ICD-10-CM does not list Includes notes for F12.19 in this effective period.

Excludes 1

Official

cannabis dependence (F12.2-)
cannabis use, unspecified (F12.9-)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for F12.19 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for F12.19 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for F12.19 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Documentation of cannabis abuse

Statement that a cannabis-induced disorder is present

Clinical evidence of complications beyond simple cannabis use or intoxication

Documentation of attempts to clarify the specific disorder type

MEAT Support

HCC Buddy guidance

Documentation of cannabis abuse

Statement that a cannabis-induced disorder is present

Clinical evidence of complications beyond simple cannabis use or intoxication

Documentation of attempts to clarify the specific disorder type

Audit Caution

HCC Buddy guidance

Using this catch-all code without first attempting to identify the specific induced disorder

Confusing this code with F12.10 (uncomplicated) — this code requires an induced disorder to be present

Not querying the provider for details about the cannabis-induced complication

Assigning this code when documentation actually supports a more specific induced disorder

Common Mistakes

HCC Buddy guidance

F12.10 — Cannabis abuse, uncomplicated; use when no induced disorder is present

F12.188 — Cannabis abuse with other cannabis-induced disorder; use when the specific disorder IS identified

F12.180 — Cannabis abuse with cannabis-induced anxiety disorder; use when anxiety is the specific disorder

F12.29 — Cannabis dependence with unspecified cannabis-induced disorder; use when dependence is documented

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Is F12.19 an HCC code?

Yes. F12.19 maps to Drug/Alcohol Dependence under the V24 model but is not retained in V28.

HCC Category Mapping

V24HCC 55, Drug/Alcohol Dependence

0.334

ESRDHCC 55, Drug/Alcohol Dependence

0.000

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 F12.19

For F12.19to 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 F12.19 during that encounter, not just copy-forwarded from a problem list.

What This Code Means

F12.19 is the ICD-10-CM diagnosis code for cannabis abuse with unspecified cannabis-induced disorder. A person who abuses cannabis and has developed a cannabis-related health problem, but the specific type of problem is not documented or identified. F12.19 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, F12.19 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 the specific cannabis-induced disorder cannot be determined from documentation. Because F12.19 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 F12.19 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 the specific cannabis-induced disorder cannot be determined from documentation
•Query the provider if additional details about the induced disorder are available to allow for more specific coding

Clinical Significance

Cannabis abuse with unspecified cannabis-induced disorder represents the least specific code for cannabis abuse with an induced complication. It is used when documentation confirms a cannabis-induced disorder exists but the specific type cannot be determined. This code signals a documentation improvement opportunity — providers should be queried to identify the specific induced disorder for more precise coding and better clinical care planning.

Documentation Requirements

✓Documentation of cannabis abuse
✓Statement that a cannabis-induced disorder is present
✓Clinical evidence of complications beyond simple cannabis use or intoxication
✓Documentation of attempts to clarify the specific disorder type

Commonly Confused Codes

•F12.10: Cannabis abuse, uncomplicated; use when no induced disorder is present
•F12.188: Cannabis abuse with other cannabis-induced disorder; use when the specific disorder IS identified
•F12.180: Cannabis abuse with cannabis-induced anxiety disorder; use when anxiety is the specific disorder
•F12.29: Cannabis dependence with unspecified cannabis-induced disorder; use when dependence is documented