F13.182
BillableSedative, hypnotic or anxiolytic abuse with sedative, hypnotic or anxiolytic-induced sleep disorder
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F13.182 an HCC code?
Yes. F13.182 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 F13.182
For F13.182 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 F13.182 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F13.182 is the ICD-10-CM diagnosis code for sedative, hypnotic or anxiolytic abuse with sedative, hypnotic or anxiolytic-induced sleep disorder. Misuse of sedatives, sleeping pills, or anti-anxiety medications that causes sleep disturbances such as insomnia or abnormal sleep patterns. F13.182 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, F13.182 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, F13.182 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 sleep problem (insomnia, hypersomnia, parasomnia) when possible. Because F13.182 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 F13.182 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document the specific sleep problem (insomnia, hypersomnia, parasomnia) when possible
- •This paradoxically reflects sleep disorders caused by substances meant to improve sleep
Clinical Significance
Sleep disorder induced by sedatives represents a paradoxical clinical scenario where medications designed to promote sleep actually cause sleep disturbances. This is commonly seen with chronic benzodiazepine use and indicates a clinically significant complication of substance abuse. The presence of an induced disorder reflects greater disease burden than uncomplicated abuse and carries implications for both treatment planning and risk adjustment.
Documentation Requirements
- ✓Specific sedative, hypnotic, or anxiolytic substance identified
- ✓Type of sleep disturbance documented (insomnia, hypersomnia, parasomnia, circadian rhythm disruption)
- ✓Provider attribution of sleep disorder to the substance use
- ✓Substance use pattern meeting abuse criteria
- ✓Differentiation from rebound insomnia during withdrawal versus ongoing sleep disorder during active use
- ✓Sleep assessment findings or sleep study results if available
Commonly Confused Codes
- •F13.282 — Sedative DEPENDENCE with induced sleep disorder; requires documented dependence
- •F13.982 — Unspecified sedative use with induced sleep disorder; use when abuse vs dependence is unclear
- •G47.00 — Insomnia, unspecified; does not capture substance-induced etiology
- •F13.10 — Uncomplicated sedative abuse; misses the sleep disorder complication
- •F13.230 — Sedative dependence with withdrawal uncomplicated; withdrawal-related sleep issues differ from induced sleep disorder