F12.920 ICD-10-CM Code: Cannabis use, unspecified with intoxication, uncomplicated
F12.920 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC coding software
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FY 2026 Apr update / Mental, Behavioral and Neurodevelopmental disorders (F01-F99) / Mental and behavioral disorders due to psychoactive substance use (F10-F19)
F12.920
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceCannabis use, unspecified with intoxication, uncomplicated
A person who uses cannabis without dependence and experiences intoxication (being high) without hallucinations or other perceptual disturbances.
Buddy Insight
Cannabis use, unspecified with uncomplicated intoxication is used when a patient is intoxicated from cannabis but the severity of the use disorder (abuse vs.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
MappedHCC 082
Code-level coefficient reference
ESRD/PACE
MappedHCC 55
Code-level coefficient reference
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialNo inclusion terms are included in this display for F12.920. 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
Related Codes
Includes
Official- disorders of psychological developmentInherited from F01-F99, F12
- marijuanaInherited from F01-F99, F12
Excludes 1
Official- cannabis abuse (F12.1-)Inherited from F12.9
- cannabis dependence (F12.2-)Inherited from F12.9
Code First
OfficialNo Code First sequencing instructions are included in this display for F12.920. Check the code and parent instructions in the Code Book.
Use Additional
OfficialNo Use Additional Code instructions are included in this display for F12.920. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for F12.920. Check the code and parent instructions in the Code Book.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
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 F12.920 an HCC code?
F12.920 has no mapping under the current CMS-HCC V28 community payment model. F12.920 has a separate mapping under the CMS-HCC ESRD model (HCC 55 (Substance Use Disorder/Moderate/Severe/Substance Use with Complications)); the applicable result needs member context. F12.920 also appears in the HHS-HCC commercial risk model (HCC 082 (HHS-HCC 082 adult, RAF varies by metal level)), which is a commercial market model rather than a Medicare Advantage payment mapping.
- Code
- F12.920
- Description
- Cannabis use, unspecified with intoxication, uncomplicated
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF reference coefficient
- —
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
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 F12.920 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT review for F12.920
For F12.920, 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
F12.920 is the ICD-10-CM diagnosis code for cannabis use, unspecified with intoxication, uncomplicated. A person who uses cannabis without dependence and experiences intoxication (being high) without hallucinations or other perceptual disturbances. F12.920 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).
F12.920 has no mapping under the current CMS-HCC V28 community payment model. F12.920 has a separate mapping under the CMS-HCC ESRD model (HCC 55 (Substance Use Disorder/Moderate/Severe/Substance Use with Complications)); the applicable result needs member context. F12.920 also appears in the HHS-HCC commercial risk model (HCC 082 (HHS-HCC 082 adult, RAF varies by metal level)), which is a commercial market model rather than a Medicare Advantage payment mapping. Do not assign V28 risk adjustment value from this page; verify the applicable model and payment year before using this code for risk adjustment.
The fifth character '0' indicates uncomplicated intoxication; do not use if perceptual disturbances are present.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for F12.920 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •The fifth character '0' indicates uncomplicated intoxication; do not use if perceptual disturbances are present
- •Document the acute intoxication state and confirm absence of perceptual symptoms in the clinical note
Clinical Significance
Cannabis use, unspecified with uncomplicated intoxication is used when a patient is intoxicated from cannabis but the severity of the use disorder (abuse vs. dependence) is not documented. This code captures the clinical event but indicates a documentation gap regarding the severity of the patient's cannabis use pattern. Coders should query providers to determine if abuse or dependence criteria are met for more specific coding.
Documentation Requirements
- ✓Documentation of cannabis use
- ✓Evidence of current intoxication at the encounter
- ✓Description of intoxication symptoms
- ✓Confirmation of uncomplicated intoxication — no delirium or perceptual disturbances
- ✓Documentation of why severity of use disorder could not be determined
Commonly Confused Codes
- •F12.120: Cannabis abuse with intoxication, uncomplicated; use when abuse is documented
- •F12.220: Cannabis dependence with intoxication, uncomplicated; use when dependence is documented
- •F12.921: Cannabis use, unspecified with intoxication delirium; use when delirium is present
- •F12.922: Cannabis use, unspecified with intoxication with perceptual disturbance; use when perceptual changes occur