F13.14
BillableSedative, hypnotic or anxiolytic abuse with sedative, hypnotic or anxiolytic-induced mood disorder
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F13.14 an HCC code?
Yes. F13.14 maps to Drug Use Disorder/Substance Use Disorder, Moderate/Severe under the CMS-HCC V28 risk adjustment model (and Drug/Alcohol Dependence under V24).
HCC Category Mapping
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.
MEAT Criteria for F13.14
For F13.14 to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically — it has to be re-documented and supported each calendar year.
- 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
Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed F13.14 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F13.14 is the ICD-10-CM diagnosis code for sedative, hypnotic or anxiolytic abuse with sedative, hypnotic or anxiolytic-induced mood disorder. Misuse of sedatives, sleeping pills, or anti-anxiety medications that causes mood disorders such as depression or emotional instability. F13.14 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, F13.14 maps to Drug Use Disorder/Substance Use Disorder, Moderate/Severe (HCC 137) with a community, non-dual, aged base RAF weight of 0.358. Under the older CMS-HCC V24 model, F13.14 maps to Drug/Alcohol Dependence (HCC 55) with a community, non-dual, aged base RAF weight of 0.334. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.
Document the specific mood disorder (depression, bipolar, etc.) in the clinical record for clarity. Because F13.14 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. 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, RAF weights, and MEAT documentation criteria for F13.14 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document the specific mood disorder (depression, bipolar, etc.) in the clinical record for clarity
- •This code indicates the substance-induced nature of the mood disorder, not a primary mood disorder
Clinical Significance
Sedative, hypnotic, or anxiolytic abuse with substance-induced mood disorder captures the development of depression, mania, or mixed mood states caused by misuse of sedating medications. Sedative-induced mood disorders are common, particularly depression, and can complicate treatment because the mood symptoms may persist even after cessation of the abused substance. This diagnosis is important for comprehensive psychiatric care planning and risk adjustment.
Documentation Requirements
- ✓Documentation of sedative/hypnotic/anxiolytic abuse
- ✓Description of the specific mood disturbance (depression, mania, mixed features)
- ✓Clinical statement that mood disorder is induced by the sedative substance, not a primary mood disorder
- ✓Temporal relationship between substance use and mood symptoms
- ✓Assessment of suicide risk if depressive features are present
- ✓Exclusion of primary mood disorders (major depressive disorder, bipolar disorder)