What is ICD-10 code F12.951?

F12.951 is the ICD-10-CM diagnosis code for Cannabis use, unspecified with psychotic disorder with hallucinations. It belongs to the ICD-10-CM chapter for mental, behavioral and neurodevelopmental disorders (f01-f99). F12.951 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. F12.951 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. F12.951 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. F12.951 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Which HCC does F12.951 map to under V28?

F12.951 maps to CMS-HCC V28 HCC 135 (Drug Use with Psychotic Complications). The category numbers, labels, and conditions come from the CMS-HCC V28 model file for payment year 2026.

2026 ICD-10-CM F12.951: Cannabis use, unspecified

F12.951 maps to CMS-HCC V28 135. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · free HCC coding tools

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupF12.951

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)

F12.951

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

Cannabis use, unspecified with psychotic disorder with hallucinations

A person uses cannabis in an unspecified pattern and is experiencing a mental health condition involving hallucinations (seeing or hearing things that aren't real). This code indicates the cannabis use and psychotic symptoms are related.

Buddy Insight

Cannabis use, unspecified with psychotic disorder with hallucinations documents cannabis-induced psychosis featuring hallucinations when the use disorder severity is not specified.

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

Mapped

HCC 135

Drug Use with Psychotic Compl...

Code-level coefficient reference

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 081

HHS-HCC 081 adult, RAF varies...

Code-level coefficient reference

ESRD/PACE

Mapped

HCC 54

Substance Use with Psychotic ...

Code-level coefficient reference

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

F12.9Cannabis use, unspecified F12.95Cannabis use, unspecified with psychotic disorder F12.951Cannabis use, unspecified with psychotic disorder with hallucinations

Inclusion Terms

Official

No inclusion terms are included in this display for F12.951. 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

Official

F12.950Cannabis use, unspecified with psychotic disorder with delusions F12.959Cannabis use, unspecified with psychotic disorder, unspecified

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

Official

No Code First sequencing instructions are included in this display for F12.951. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for F12.951. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for F12.951. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Documentation of cannabis use

Description of specific hallucinations (auditory, visual, tactile, olfactory)

Clinical statement that hallucinations are cannabis-induced

Evidence that hallucinations persist beyond the intoxication period

MEAT Support

HCC Buddy guidance

Documentation of cannabis use

Description of specific hallucinations (auditory, visual, tactile, olfactory)

Clinical statement that hallucinations are cannabis-induced

Evidence that hallucinations persist beyond the intoxication period

Audit Caution

HCC Buddy guidance

Confusing intoxication-related perceptual disturbances with substance-induced psychotic disorder

Not querying for the severity of the cannabis use disorder

Coding as primary schizophrenia when cannabis is the documented etiology

Using the unspecified psychotic disorder code when hallucinations are specifically documented

Common Mistakes

HCC Buddy guidance

F12.151 — Cannabis abuse with psychotic disorder with hallucinations; use when abuse is documented

F12.251 — Cannabis dependence with psychotic disorder with hallucinations; use when dependence is documented

F12.922 — Cannabis use, unspecified with intoxication with perceptual disturbance; use when symptoms occur only during intoxication

F20.x — Schizophrenia; use for primary psychotic disorder not substance-induced

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 F12.951 an HCC code?

Yes. F12.951 (Cannabis use, unspecified with psychotic disorder with hallucinations) maps to HCC 135, Drug Use with 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: F12.951 is billable and maps to V28 HCC 135, Drug Use with Psychotic Complications. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code: F12.951
Description: Cannabis use, unspecified with psychotic disorder with hallucinations
HCC (V28): HCC 135 — Drug Use with Psychotic Complications
RAF reference coefficient: 0.424
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 135, Drug Use with Psychotic Complications

0.424

ESRDHCC 54, Substance Use with Psychotic 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 F12.951 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for F12.951

For F12.951, 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

Get the V28 mapping + MEAT cheat sheet

One printable reference: check representative V28 mappings and the documentation reminders your note needs. Free, no card.

Free PDF. No card. Unsubscribe anytime.

What This Code Means

F12.951 is the ICD-10-CM diagnosis code for cannabis use, unspecified with psychotic disorder with hallucinations. A person uses cannabis in an unspecified pattern and is experiencing a mental health condition involving hallucinations (seeing or hearing things that aren't real). This code indicates the cannabis use and psychotic symptoms are related. F12.951 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, F12.951 maps to Drug Use with Psychotic Complications (HCC 135) with a source-labeled community, non-dual, aged reference coefficient of 0.424. No V24 mapping is shown for F12.951; use the applicable model and payment year when reviewing the V28 mapping. 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.

Verify documentation clearly links cannabis use to the psychotic symptoms with hallucinations; if the relationship is unclear, query the provider before coding. For F12.951, 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 F12.951 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Verify documentation clearly links cannabis use to the psychotic symptoms with hallucinations; if the relationship is unclear, query the provider before coding
•Ensure the cannabis use pattern is documented; if specific frequency/remission status cannot be determined, 'unspecified' is appropriate, but check for any documentation of use severity

Clinical Significance

Cannabis use, unspecified with psychotic disorder with hallucinations documents cannabis-induced psychosis featuring hallucinations when the use disorder severity is not specified. Hallucinations persisting beyond intoxication in the context of cannabis use represent a significant psychiatric emergency. This diagnosis is important for both clinical management and risk adjustment, as it captures the highest substance use HCC category in the V24 model.

Documentation Requirements

✓Documentation of cannabis use
✓Description of specific hallucinations (auditory, visual, tactile, olfactory)
✓Clinical statement that hallucinations are cannabis-induced
✓Evidence that hallucinations persist beyond the intoxication period
✓Mental status examination documenting hallucinatory experiences
✓Exclusion of primary psychotic disorders and other causes of hallucinations

Commonly Confused Codes

•F12.151: Cannabis abuse with psychotic disorder with hallucinations; use when abuse is documented
•F12.251: Cannabis dependence with psychotic disorder with hallucinations; use when dependence is documented
•F12.922: Cannabis use, unspecified with intoxication with perceptual disturbance; use when symptoms occur only during intoxication
•F20.x: Schizophrenia; use for primary psychotic disorder not substance-induced