F12.280
BillableCannabis dependence with cannabis-induced anxiety disorder
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F12.280 an HCC code?
Yes. F12.280 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
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 F12.280
For F12.280 to 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 F12.280 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F12.280 is the ICD-10-CM diagnosis code for cannabis dependence with cannabis-induced anxiety disorder. A person who is dependent on cannabis and experiences anxiety disorder as a direct result of their cannabis use. F12.280 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, F12.280 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, F12.280 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.
This code requires documentation of both cannabis dependence AND cannabis-induced anxiety; do not use if anxiety exists independently. Because F12.280 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 F12.280 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This code requires documentation of both cannabis dependence AND cannabis-induced anxiety; do not use if anxiety exists independently
- •Verify in the clinical record that the anxiety disorder is temporally related to cannabis use and not a pre-existing condition
Clinical Significance
Cannabis dependence with cannabis-induced anxiety disorder captures a patient who meets criteria for cannabis dependence and has developed a clinically significant anxiety disorder as a direct result of cannabis use. This combination reflects dual psychiatric morbidity and often complicates treatment because the anxiety may both drive and result from continued cannabis use. Appropriate documentation supports both clinical care and accurate risk stratification.
Documentation Requirements
- ✓Documentation of cannabis dependence criteria
- ✓Specific anxiety symptoms (generalized anxiety, panic attacks, social anxiety, etc.)
- ✓Clinical statement that anxiety disorder is induced by cannabis use
- ✓Temporal relationship between cannabis use and anxiety
- ✓Exclusion of primary anxiety disorders that exist independently of cannabis use
- ✓Assessment of the interplay between dependence and anxiety in the treatment plan
Commonly Confused Codes
- •F12.180 — Cannabis abuse with cannabis-induced anxiety disorder; use when only abuse is documented
- •F12.980 — Cannabis use, unspecified with anxiety disorder; use when severity of use disorder is unspecified
- •F41.1 — Generalized anxiety disorder; use for primary anxiety not substance-induced
- •F12.20 — Cannabis dependence, uncomplicated; use when no anxiety disorder is present