F12.99 ICD-10-CM Code: Cannabis use, unspecified with unspecified cannabis-induced disorder
F12.99 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · free HCC coding tools
HCC Buddy Code Card
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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)
F12.99
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceCannabis use, unspecified with unspecified cannabis-induced disorder
A person uses cannabis in an unspecified pattern and has a cannabis-related health problem, but the specific type of problem is not documented or identified.
Buddy Insight
Cannabis use, unspecified with unspecified cannabis-induced disorder is the least specific code available for cannabis use with a complication.
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 F12.99. 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 F12.99. Check the code and parent instructions in the Code Book.
Use Additional
OfficialNo Use Additional Code instructions are included in this display for F12.99. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for F12.99. 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 F12.99 an HCC code?
F12.99 has no mapping under the current CMS-HCC V28 community payment model. F12.99 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. F12.99 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
- F12.99
- Description
- Cannabis use, unspecified with unspecified cannabis-induced disorder
- 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 F12.99 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT review for F12.99
For F12.99, 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
F12.99 is the ICD-10-CM diagnosis code for cannabis use, unspecified with unspecified cannabis-induced disorder. A person uses cannabis in an unspecified pattern and has a cannabis-related health problem, but the specific type of problem is not documented or identified. F12.99 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).
F12.99 has no mapping under the current CMS-HCC V28 community payment model. F12.99 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. F12.99 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.
This is a catch-all code; request clarification from the provider about the specific cannabis-induced disorder when possible.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for F12.99 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This is a catch-all code; request clarification from the provider about the specific cannabis-induced disorder when possible
- •Use only when the induced disorder cannot be determined from available documentation
Clinical Significance
Cannabis use, unspecified with unspecified cannabis-induced disorder is the least specific code available for cannabis use with a complication. Both the severity of the use disorder and the type of induced disorder are unspecified. This code should be used only as a last resort when documentation is insufficient, and providers should be queried for additional detail to support more precise coding. Despite its lack of specificity, it still represents clinically relevant cannabis-related morbidity.
Documentation Requirements
- ✓Documentation of cannabis use
- ✓Statement that a cannabis-induced disorder is present
- ✓Any available clinical information
- ✓Documentation of query attempts to determine more specific information
Commonly Confused Codes
- •F12.90: Cannabis use, unspecified, uncomplicated; use when no induced disorder is present
- •F12.988: Cannabis use, unspecified with other cannabis-induced disorder; use when the specific disorder IS identified
- •F12.980: Cannabis use, unspecified with anxiety disorder; use when anxiety is specified
- •F12.29: Cannabis dependence with unspecified cannabis-induced disorder; use when dependence is documented