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.

What is the V28 vs V24 difference for F12.220?

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. For F12.220, V28 maps to Drug Use Disorder/Substance Use Disorder, Moderate/Severe at RAF 0.358 while V24 mapped to Drug/Alcohol Dependence at RAF 0.334. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting 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 Because F12.220 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.

F12.220 ICD-10 Code: Cannabis dependence

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 lookupF12.220Effective 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

CMS-HCC V28

Mapped

HCC 137

Drug Use Disorder/Substance U...

RAF 0.358

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

Basket needed

Compare selected patient codes to show trumped or trumps impact.

Code Book Path

Official

F12.2Cannabis dependence

F12.22Cannabis dependence with intoxication

F12.220Cannabis dependence with intoxication, uncomplicated

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for F12.220 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for F12.220 in this effective period.

Related Child Codes

Official

F12.221Cannabis dependence with intoxication delirium

F12.222Cannabis dependence with intoxication with perceptual disturbance

F12.229Cannabis dependence with intoxication, unspecified

Includes

Official

ICD-10-CM does not list Includes notes for F12.220 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for F12.220 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for F12.220 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for F12.220 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for F12.220 in this effective period.

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

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 F12.220 an HCC code?

Yes. F12.220 maps to Drug Use Disorder/Substance Use Disorder, Moderate/Severe under the CMS-HCC V28 risk adjustment model (and Drug/Alcohol Dependence under V24).

HCC Category Mapping

V28HCC 137, Drug Use Disorder/Substance Use Disorder, Moderate/Severe

0.358

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 F12.220

For F12.220to 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 F12.220 during that encounter, not just copy-forwarded from a problem list.

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/Substance Use Disorder, Moderate/Severe (HCC 137) with a community, non-dual, aged base RAF weight of 0.358. Under the older CMS-HCC V24 model, F12.220 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.

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. Because F12.220 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 F12.220 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