F12.921 ICD-10-CM Code: Cannabis use, unspecified with intoxication delirium
F12.921 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · free HCC coding tools
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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)
F12.921
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceCannabis use, unspecified with intoxication delirium
This code describes a patient who uses cannabis in an unspecified pattern and is currently experiencing delirium (confusion, disorientation, and altered mental state) due to cannabis intoxication. Delirium is a serious acute mental state where the person is confused about time, place, or identity.
Buddy Insight
Cannabis use, unspecified with intoxication delirium identifies a patient with cannabis-related intoxication delirium when the severity of the underlying use disorder is not documented.
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 F12.921. 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 F12.921. Check the code and parent instructions in the Code Book.
Use Additional
OfficialNo Use Additional Code instructions are included in this display for F12.921. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for F12.921. 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 F12.921 an HCC code?
F12.921 is not in the CMS-HCC V28 or V24 community payment model. F12.921 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. F12.921 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
- F12.921
- Description
- Cannabis use, unspecified with intoxication delirium
- 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 F12.921 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT review for F12.921
For F12.921, 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
F12.921 is the ICD-10-CM diagnosis code for cannabis use, unspecified with intoxication delirium. This code describes a patient who uses cannabis in an unspecified pattern and is currently experiencing delirium (confusion, disorientation, and altered mental state) due to cannabis intoxication. Delirium is a serious acute mental state where the person is confused about time, place, or identity. F12.921 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).
F12.921 has no mapping under the CMS-HCC V28 or V24 community payment models. F12.921 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. F12.921 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.
Use this code only when documentation clearly indicates both cannabis use and active delirium symptoms caused by intoxication; do not use if the delirium is from another cause.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for F12.921 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 documentation clearly indicates both cannabis use and active delirium symptoms caused by intoxication; do not use if the delirium is from another cause
- •The 'unspecified' component means the pattern of use (occasional, regular, or dependent) is not documented; if use disorder severity is documented, consider codes F12.121 (mild), F12.221 (moderate), or F12.921 (severe) instead
Clinical Significance
Cannabis use, unspecified with intoxication delirium identifies a patient with cannabis-related intoxication delirium when the severity of the underlying use disorder is not documented. Delirium during cannabis intoxication is a serious acute condition requiring immediate medical attention. This diagnosis signals high clinical acuity regardless of whether the underlying pattern is abuse or dependence.
Documentation Requirements
- ✓Documentation of cannabis use
- ✓Acute delirium findings: confusion, disorientation, fluctuating consciousness, altered attention
- ✓Temporal relationship between cannabis use and delirium onset
- ✓Mental status examination documenting delirium
- ✓Exclusion of other causes of delirium
- ✓Vital signs and monitoring records
Commonly Confused Codes
- •F12.121: Cannabis abuse with intoxication delirium; use when abuse is documented
- •F12.221: Cannabis dependence with intoxication delirium; use when dependence is documented
- •F12.920: Cannabis use, unspecified with intoxication, uncomplicated; use when no delirium is present
- •F05: Delirium due to known physiological condition; use when delirium is not substance-induced