F12.229 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 lookupF12.229

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)

F12.229

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

Cannabis dependence with intoxication, unspecified

A person dependent on cannabis who is currently intoxicated, but the specific effects of the intoxication are not clearly documented.

Buddy Insight

Cannabis dependence with unspecified intoxication documents a dependent patient who is intoxicated but the specific characteristics of the intoxication are not documented.

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

Mapped

HCC 137

Drug Use Disorder, Moderate/S...

Coefficient HCC 137: 0.424 (Community Non-Dual Aged (CNA))

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 F12.229Cannabis dependence with intoxication, unspecified

Inclusion Terms

Official

No inclusion terms are included in this display for F12.229. 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

F12.220Cannabis dependence with intoxication, uncomplicated F12.221Cannabis dependence with intoxication delirium F12.222Cannabis dependence with intoxication with perceptual disturbance

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 F12.229. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for F12.229. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for F12.229. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Documentation of cannabis dependence

Evidence of current intoxication

Clinical findings from the encounter

Documentation of attempts to determine intoxication specifics

MEAT Support

HCC Buddy guidance

Documentation of cannabis dependence

Evidence of current intoxication

Clinical findings from the encounter

Documentation of attempts to determine intoxication specifics

Audit Caution

HCC Buddy guidance

Defaulting to unspecified when documentation actually supports a specific intoxication type

Not querying the provider for details about the intoxication presentation

Using this code when the patient is not actually intoxicated at the time of the encounter

Confusing the abuse and dependence code series for intoxication

Common Mistakes

HCC Buddy guidance

F12.220 — Cannabis dependence with intoxication, uncomplicated; use when documentation confirms uncomplicated intoxication

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

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

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

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 F12.229 an HCC code?

Yes. F12.229 (Cannabis dependence with intoxication, unspecified) 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: F12.229 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: F12.229
Description: Cannabis dependence with intoxication, unspecified
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 F12.229 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for F12.229

For F12.229, 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

F12.229 is the ICD-10-CM diagnosis code for cannabis dependence with intoxication, unspecified. A person dependent on cannabis who is currently intoxicated, but the specific effects of the intoxication are not clearly documented. F12.229 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, F12.229 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. 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.

Use this code only when intoxication is present but the specific manifestations are not specified in the record. For F12.229, 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 F12.229 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 intoxication is present but the specific manifestations are not specified in the record
•Query the provider for clarification on intoxication symptoms to allow for more specific coding if possible

Clinical Significance

Cannabis dependence with unspecified intoxication documents a dependent patient who is intoxicated but the specific characteristics of the intoxication are not documented. This code captures the clinical event for risk adjustment but represents an opportunity for improved documentation. Querying the provider about the presence of delirium or perceptual disturbances would allow a more precise code assignment.

Documentation Requirements

✓Documentation of cannabis dependence
✓Evidence of current intoxication
✓Clinical findings from the encounter
✓Documentation of attempts to determine intoxication specifics

Commonly Confused Codes

•F12.220: Cannabis dependence with intoxication, uncomplicated; use when documentation confirms uncomplicated intoxication
•F12.221: Cannabis dependence with intoxication delirium; use when delirium is present
•F12.222: Cannabis dependence with intoxication with perceptual disturbance; use when perceptual changes occur
•F12.20: Cannabis dependence, uncomplicated; use when no intoxication is present