F12.23 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 coding software

ICD-10-CM Code View

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Code lookupF12.23

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)

F12.23

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

Cannabis dependence with withdrawal

A person dependent on cannabis who is experiencing withdrawal symptoms after stopping or reducing cannabis use.

Buddy Insight

Cannabis dependence with withdrawal documents a dependent patient actively experiencing withdrawal symptoms after reducing or stopping cannabis use.

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

Inclusion Terms

Official

No inclusion terms are included in this display for F12.23. 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

F12.20Cannabis dependence, uncomplicated F12.21Cannabis dependence, in remission F12.22Cannabis dependence with intoxication F12.25Cannabis dependence with psychotic disorder F12.28Cannabis dependence with other cannabis-induced disorder

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 F12.23. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for F12.23. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for F12.23. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Documentation of cannabis dependence criteria

Specific withdrawal symptoms (irritability, anxiety, insomnia, decreased appetite, restlessness, depressed mood, physical symptoms such as abdominal pain, shakiness, sweating, fever, chills)

Temporal relationship between cessation/reduction of cannabis use and symptom onset

Duration and severity of withdrawal symptoms

MEAT Support

HCC Buddy guidance

Documentation of cannabis dependence criteria

Specific withdrawal symptoms (irritability, anxiety, insomnia, decreased appetite, restlessness, depressed mood, physical symptoms such as abdominal pain, shakiness, sweating, fever, chills)

Temporal relationship between cessation/reduction of cannabis use and symptom onset

Duration and severity of withdrawal symptoms

Audit Caution

HCC Buddy guidance

Coding withdrawal symptoms as independent psychiatric diagnoses rather than recognizing them as part of cannabis withdrawal syndrome

Using the uncomplicated dependence code (F12.20) when active withdrawal is present

Confusing abuse-level withdrawal (F12.13) with dependence-level withdrawal (F12.23)

Not documenting the specific withdrawal symptoms, weakening the justification for this code

Common Mistakes

HCC Buddy guidance

F12.13 — Cannabis abuse with withdrawal; use when only abuse (not dependence) is documented

F12.93 — Cannabis use, unspecified with withdrawal; use when severity of use disorder is unspecified

F12.20 — Cannabis dependence, uncomplicated; use when no withdrawal symptoms are present

F41.1 — Generalized anxiety disorder; do not use when anxiety is attributable to cannabis withdrawal

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 F12.23 an HCC code?

Yes. F12.23 (Cannabis dependence with withdrawal) 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: F12.23 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: F12.23
Description: Cannabis dependence with withdrawal
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 F12.23 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for F12.23

For F12.23, 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

F12.23 is the ICD-10-CM diagnosis code for cannabis dependence with withdrawal. A person dependent on cannabis who is experiencing withdrawal symptoms after stopping or reducing cannabis use. F12.23 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, F12.23 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.

Document specific withdrawal symptoms such as irritability, sleep disturbance, anxiety, or appetite changes. For F12.23, 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 F12.23 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Document specific withdrawal symptoms such as irritability, sleep disturbance, anxiety, or appetite changes
•Cannabis withdrawal is typically less severe than alcohol or opioid withdrawal but still clinically significant

Clinical Significance

Cannabis dependence with withdrawal documents a dependent patient actively experiencing withdrawal symptoms after reducing or stopping cannabis use. Cannabis withdrawal syndrome — including irritability, anxiety, insomnia, decreased appetite, restlessness, and depressed mood — is now a formally recognized diagnosis. Documenting withdrawal confirms physiological dependence and supports the need for medically supervised cessation or tapering strategies.

Documentation Requirements

✓Documentation of cannabis dependence criteria
✓Specific withdrawal symptoms (irritability, anxiety, insomnia, decreased appetite, restlessness, depressed mood, physical symptoms such as abdominal pain, shakiness, sweating, fever, chills)
✓Temporal relationship between cessation/reduction of cannabis use and symptom onset
✓Duration and severity of withdrawal symptoms
✓Treatment plan for withdrawal management

Commonly Confused Codes

•F12.13: Cannabis abuse with withdrawal; use when only abuse (not dependence) is documented
•F12.93: Cannabis use, unspecified with withdrawal; use when severity of use disorder is unspecified
•F12.20: Cannabis dependence, uncomplicated; use when no withdrawal symptoms are present
•F41.1: Generalized anxiety disorder; do not use when anxiety is attributable to cannabis withdrawal