What is ICD-10 code F12.220?

F12.220 is the ICD-10-CM diagnosis code for Cannabis dependence with intoxication, uncomplicated. It belongs to the ICD-10-CM chapter for mental, behavioral and neurodevelopmental disorders (f01-f99). F12.220 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. F12.220 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. F12.220 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. F12.220 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.

Which HCC does F12.220 map to under V28?

F12.220 maps to CMS-HCC V28 HCC 137 (Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications). The category numbers, labels, and conditions come from the CMS-HCC V28 model file for payment year 2026.

What documentation supports F12.220?

Verify documentation clearly states both cannabis dependence AND current intoxication to justify this specific code; if only dependence is documented without active intoxication, use F12.20 instead Ensure the intoxication is documented as 'uncomplicated' - if there are complications such as anxiety, paranoia, or other mental health effects, use a different F12.22x code variant For F12.220, 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. See the MEAT criteria checklist at /meat-criteria for what Monitor, Evaluate, Assess, or Treat looks like in a note. One mnemonic element does not establish that a diagnosis is reportable.

2026 ICD-10-CM F12.220: Cannabis dependence

F12.220 maps to CMS-HCC V28 137. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · HCC Buddy coding tools

ICD-10-CM Code View

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Code lookupF12.220

Effective 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)

F12.220

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

Cannabis dependence with intoxication, uncomplicated

This code describes a patient who is dependent on cannabis (marijuana) and is currently intoxicated from using it, without any additional complications like withdrawal or perceptual disturbances. It indicates an ongoing substance use disorder with active intoxication at the time of assessment.

Buddy Insight

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

Mapped

HCC 137

Drug Use Disorder, Moderate/S...

Code-level coefficient reference

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

Mapped

HCC 082

HHS-HCC 082 adult, RAF varies...

Code-level coefficient reference

ESRD/PACE

Mapped

HCC 55

Substance Use Disorder/Modera...

Code-level coefficient reference

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

F12.2Cannabis dependence F12.22Cannabis dependence with intoxication F12.220Cannabis dependence with intoxication, uncomplicated

Inclusion Terms

Official

No inclusion terms are included in this display for F12.220. 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, F12.2
cannabis poisoning (T40.7-)Inherited from F01-F99, F12.2

Related Codes

Official

F12.221Cannabis dependence with intoxication delirium F12.222Cannabis dependence with intoxication with perceptual disturbance F12.229Cannabis dependence with intoxication, unspecified

Includes

Official

disorders of psychological developmentInherited from F01-F99, F12
marijuanaInherited from F01-F99, F12

Excludes 1

Official

cannabis abuse (F12.1-)Inherited from F12.2
cannabis use, unspecified (F12.9-)Inherited from F12.2

Code First

Official

No Code First sequencing instructions are included in this display for F12.220. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for F12.220. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for F12.220. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Documentation of cannabis dependence (tolerance, withdrawal history, compulsive use)

Evidence of current intoxication at the encounter

Description of intoxication symptoms (euphoria, impaired coordination, slowed reactions)

Confirmation that intoxication is uncomplicated — no delirium or perceptual disturbances

MEAT Support

HCC Buddy guidance

Documentation of cannabis dependence (tolerance, withdrawal history, compulsive use)

Evidence of current intoxication at the encounter

Description of intoxication symptoms (euphoria, impaired coordination, slowed reactions)

Confirmation that intoxication is uncomplicated — no delirium or perceptual disturbances

Audit Caution

HCC Buddy guidance

Coding intoxication without first establishing the dependence level of the use disorder

Using uncomplicated intoxication when delirium or perceptual disturbances are documented

Confusing the abuse (F12.12x) and dependence (F12.22x) intoxication code series

Assigning the base dependence code (F12.20) when intoxication is documented — the combination code should be used

Common Mistakes

HCC Buddy guidance

F12.20 — Cannabis dependence, uncomplicated; use when no intoxication is present

F12.221 — Cannabis dependence with intoxication delirium; use when delirium accompanies intoxication

F12.222 — Cannabis dependence with intoxication with perceptual disturbance; use when perceptual changes occur

F12.120 — Cannabis abuse with intoxication, uncomplicated; use when only abuse (not dependence) is documented

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 F12.220 an HCC code?

Yes. F12.220 (Cannabis dependence with intoxication, uncomplicated) maps to HCC 137, Drug Use Disorder, Moderate/Severe, or Drug Use with Non-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: F12.220 is billable and maps to V28 HCC 137, Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code: F12.220
Description: Cannabis dependence with intoxication, uncomplicated
HCC (V28): HCC 137 — Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications
RAF reference coefficient: 0.424
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 137, Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications

0.424

ESRDHCC 55, Substance Use Disorder/Moderate/Severe/Substance Use with Complications

Not separately weighted

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 F12.220 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for F12.220

For F12.220, 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

F12.220 is the ICD-10-CM diagnosis code for cannabis dependence with intoxication, uncomplicated. This code describes a patient who is dependent on cannabis (marijuana) and is currently intoxicated from using it, without any additional complications like withdrawal or perceptual disturbances. It indicates an ongoing substance use disorder with active intoxication at the time of assessment. F12.220 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, F12.220 maps to Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications (HCC 137) with a source-labeled community, non-dual, aged reference coefficient of 0.424. No V24 mapping is shown for F12.220; 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.

Verify documentation clearly states both cannabis dependence AND current intoxication to justify this specific code; if only dependence is documented without active intoxication, use F12.20 instead. For F12.220, 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 F12.220 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Verify documentation clearly states both cannabis dependence AND current intoxication to justify this specific code; if only dependence is documented without active intoxication, use F12.20 instead
•Ensure the intoxication is documented as 'uncomplicated' - if there are complications such as anxiety, paranoia, or other mental health effects, use a different F12.22x code variant

Clinical Significance

Cannabis dependence with uncomplicated intoxication captures a patient who meets criteria for cannabis dependence and is currently intoxicated at the time of the clinical encounter without additional complications. This combination indicates active substance use despite a documented dependence disorder, which is relevant for treatment planning and reflects ongoing disease burden. The dual documentation of dependence and active intoxication provides important clinical context.

Documentation Requirements

✓Documentation of cannabis dependence (tolerance, withdrawal history, compulsive use)
✓Evidence of current intoxication at the encounter
✓Description of intoxication symptoms (euphoria, impaired coordination, slowed reactions)
✓Confirmation that intoxication is uncomplicated — no delirium or perceptual disturbances
✓Assessment of safety and need for monitoring

Commonly Confused Codes

•F12.20: Cannabis dependence, uncomplicated; use when no intoxication is present
•F12.221: Cannabis dependence with intoxication delirium; use when delirium accompanies intoxication
•F12.222: Cannabis dependence with intoxication with perceptual disturbance; use when perceptual changes occur
•F12.120: Cannabis abuse with intoxication, uncomplicated; use when only abuse (not dependence) is documented