F12.922 ICD-10-CM Code: Cannabis use, unspecified with intoxication with perceptual disturbance
F12.922 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC Buddy 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)
F12.922
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceCannabis use, unspecified with intoxication with perceptual disturbance
A person who uses cannabis without dependence and experiences intoxication with hallucinations, delusions, or other distorted perceptions.
Buddy Insight
Cannabis use, unspecified with intoxication with perceptual disturbance documents a patient experiencing hallucinations, illusions, or other perceptual changes during cannabis intoxication when the severity of the use disorder is not specified.
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 F12.922. 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 F12.922. Check the code and parent instructions in the Code Book.
Use Additional
OfficialNo Use Additional Code instructions are included in this display for F12.922. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for F12.922. 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 F12.922 an HCC code?
F12.922 is not in the CMS-HCC V28 or V24 community payment model. F12.922 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. F12.922 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
- F12.922
- Description
- Cannabis use, unspecified with intoxication with perceptual disturbance
- 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 F12.922 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT review for F12.922
For F12.922, 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
F12.922 is the ICD-10-CM diagnosis code for cannabis use, unspecified with intoxication with perceptual disturbance. A person who uses cannabis without dependence and experiences intoxication with hallucinations, delusions, or other distorted perceptions. F12.922 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).
F12.922 has no mapping under the CMS-HCC V28 or V24 community payment models. F12.922 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. F12.922 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 '2' specifically indicates perceptual disturbances; document the type of disturbance (hallucinations, delusions, etc.).
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for F12.922 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •The fifth character '2' specifically indicates perceptual disturbances; document the type of disturbance (hallucinations, delusions, etc.)
- •Distinguish this from psychotic disorder by confirming symptoms occur only during intoxication and resolve with abstinence
Clinical Significance
Cannabis use, unspecified with intoxication with perceptual disturbance documents a patient experiencing hallucinations, illusions, or other perceptual changes during cannabis intoxication when the severity of the use disorder is not specified. Perceptual disturbances during intoxication are clinically significant as they may indicate use of high-potency cannabis products or vulnerability to psychotic symptoms. This presentation warrants close monitoring and follow-up.
Documentation Requirements
- ✓Documentation of cannabis use
- ✓Description of specific perceptual disturbances experienced
- ✓Temporal link to active cannabis intoxication
- ✓Intact reality testing (distinguishing from psychotic disorder)
- ✓Clear consciousness (distinguishing from delirium)
- ✓Assessment of risk for progression to psychotic disorder
Commonly Confused Codes
- •F12.920: Cannabis use, unspecified with intoxication, uncomplicated; use when no perceptual disturbances are present
- •F12.950-F12.959: Cannabis use, unspecified with psychotic disorder; use when psychosis persists beyond intoxication
- •F12.122: Cannabis abuse with intoxication with perceptual disturbance; use when abuse is documented
- •F12.222: Cannabis dependence with intoxication with perceptual disturbance; use when dependence is documented