F13.139 maps to CMS-HCC V28 137. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · HCC coding software

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Code lookupF13.139

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)

F13.139

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

Sedative, hypnotic or anxiolytic abuse with withdrawal, unspecified

Misuse of sedatives, sleeping pills, or anti-anxiety medications with withdrawal symptoms, but the specific withdrawal symptoms are not detailed.

Buddy Insight

Sedative, hypnotic, or anxiolytic abuse with unspecified withdrawal is used when withdrawal from these substances is documented but the specific features are not detailed.

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

Mapped

HCC 137

Drug Use Disorder, Moderate/S...

Coefficient HCC 137: 0.424 (Community Non-Dual Aged (CNA))

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 082

HHS-HCC 082 adult, RAF varies...

Code-level coefficient reference

ESRD/PACE

Mapped

HCC 55

Substance Use Disorder/Modera...

Code-level coefficient reference

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

F13.1Sedative, hypnotic or anxiolytic-related abuse F13.13Sedative, hypnotic or anxiolytic abuse with withdrawal F13.139Sedative, hypnotic or anxiolytic abuse with withdrawal, unspecified

Inclusion Terms

Official

No inclusion terms are included in this display for F13.139. 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

F13.130Sedative, hypnotic or anxiolytic abuse with withdrawal, uncomplicated F13.131Sedative, hypnotic or anxiolytic abuse with withdrawal delirium F13.132Sedative, hypnotic or anxiolytic abuse with withdrawal with perceptual disturbance

Includes

Official

disorders of psychological developmentInherited from F01-F99

Excludes 1

Official

sedative, hypnotic or anxiolytic-related dependence (F13.2-)Inherited from F13.1
sedative, hypnotic, or anxiolytic use, unspecified (F13.9-)Inherited from F13.1

Code First

Official

No Code First sequencing instructions are included in this display for F13.139. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for F13.139. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for F13.139. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Documentation of sedative/hypnotic/anxiolytic abuse

Evidence of withdrawal symptoms

Basic clinical findings supporting withdrawal

Documentation of why more specific withdrawal details could not be determined

MEAT Support

HCC Buddy guidance

Documentation of sedative/hypnotic/anxiolytic abuse

Evidence of withdrawal symptoms

Basic clinical findings supporting withdrawal

Documentation of why more specific withdrawal details could not be determined

Audit Caution

HCC Buddy guidance

Using this unspecified code without querying for details about withdrawal severity — sedative withdrawal can be life-threatening

Not assessing for delirium or perceptual disturbances that would change the code and HCC mapping

Failing to monitor patients with sedative withdrawal for progression to seizures

Confusing abuse and dependence code series

Common Mistakes

HCC Buddy guidance

F13.130 — Sedative abuse with withdrawal, uncomplicated; use when documentation confirms uncomplicated withdrawal

F13.131 — Sedative abuse with withdrawal delirium; use when delirium is present

F13.132 — Sedative abuse with withdrawal with perceptual disturbance; use when hallucinations occur

F13.10 — Sedative abuse, uncomplicated; use when no withdrawal is present

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 F13.139 an HCC code?

Yes. F13.139 (Sedative, hypnotic or anxiolytic abuse with withdrawal, unspecified) maps to HCC 137, Drug Use Disorder, Moderate/Severe, or Drug Use with Non-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: F13.139 is billable and maps to V28 HCC 137, Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code: F13.139
Description: Sedative, hypnotic or anxiolytic abuse with withdrawal, unspecified
HCC (V28): HCC 137 — Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications
RAF reference coefficient: 0.424
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 137, Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications

0.424

ESRDHCC 55, Substance Use Disorder/Moderate/Severe/Substance Use with 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 F13.139 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for F13.139

For F13.139, 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

F13.139 is the ICD-10-CM diagnosis code for sedative, hypnotic or anxiolytic abuse with withdrawal, unspecified. Misuse of sedatives, sleeping pills, or anti-anxiety medications with withdrawal symptoms, but the specific withdrawal symptoms are not detailed. F13.139 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, F13.139 maps to Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications (HCC 137) with a source-labeled community, non-dual, aged reference coefficient of 0.424. 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.

Use this code when withdrawal is documented but lacks specificity; consider querying for more detailed withdrawal symptoms. For F13.139, 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 F13.139 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Use this code when withdrawal is documented but lacks specificity; consider querying for more detailed withdrawal symptoms
•This is a less specific code; if withdrawal details are available, use more specific F13.13x codes

Clinical Significance

Sedative, hypnotic, or anxiolytic abuse with unspecified withdrawal is used when withdrawal from these substances is documented but the specific features are not detailed. Given the potential life-threatening nature of sedative withdrawal (seizures, delirium), this documentation gap is clinically concerning. Providers should be queried about the presence of delirium, perceptual disturbances, or seizures to assign a more specific and clinically appropriate code.

Documentation Requirements

✓Documentation of sedative/hypnotic/anxiolytic abuse
✓Evidence of withdrawal symptoms
✓Basic clinical findings supporting withdrawal
✓Documentation of why more specific withdrawal details could not be determined

Commonly Confused Codes

•F13.130: Sedative abuse with withdrawal, uncomplicated; use when documentation confirms uncomplicated withdrawal
•F13.131: Sedative abuse with withdrawal delirium; use when delirium is present
•F13.132: Sedative abuse with withdrawal with perceptual disturbance; use when hallucinations occur
•F13.10: Sedative abuse, uncomplicated; use when no withdrawal is present