What is ICD-10 code F13.229?

F13.229 is the ICD-10-CM diagnosis code for Sedative, hypnotic or anxiolytic dependence with intoxication, unspecified. A person dependent on sedative, hypnotic, or anti-anxiety medications is experiencing intoxication, but the specific details or severity of the intoxication are not documented. F13.229 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. F13.229 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. F13.229 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. F13.229 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 F13.229 map to under V28?

F13.229 maps to CMS-HCC V28 HCC 137 (Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications). The category numbers, labels, and conditions come from the CMS-HCC V28 model file for payment year 2026.

2026 ICD-10-CM F13.229: Sedative, hypnotic

F13.229 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

ICD-10-CM Code View

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Code lookupF13.229

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)

F13.229

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

Sedative, hypnotic or anxiolytic dependence with intoxication, unspecified

A person dependent on sedative, hypnotic, or anti-anxiety medications is experiencing intoxication, but the specific details or severity of the intoxication are not documented.

Buddy Insight

This code indicates sedative dependence with intoxication where the severity or complications of the intoxication are not specified.

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

Mapped

HCC 137

Drug Use Disorder, Moderate/S...

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 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

F13.2Sedative, hypnotic or anxiolytic-related dependence F13.22Sedative, hypnotic or anxiolytic dependence with intoxication F13.229Sedative, hypnotic or anxiolytic dependence with intoxication, unspecified

Inclusion Terms

Official

No inclusion terms are included in this display for F13.229. 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, F13.2
sedative, hypnotic, or anxiolytic poisoning (T42.-)Inherited from F01-F99, F13.2

Related Codes

Official

F13.220Sedative, hypnotic or anxiolytic dependence with intoxication, uncomplicated F13.221Sedative, hypnotic or anxiolytic dependence with intoxication delirium

Includes

Official

disorders of psychological developmentInherited from F01-F99

Excludes 1

Official

sedative, hypnotic or anxiolytic-related abuse (F13.1-)Inherited from F13.2, F13.22
sedative, hypnotic, or anxiolytic use, unspecified (F13.9-)Inherited from F13.2, F13.22
sedative, hypnotic or anxiolytic dependence with withdrawal (F13.23-)Inherited from F13.2, F13.22

Code First

Official

No Code First sequencing instructions are included in this display for F13.229. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for F13.229. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for F13.229. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Documentation of sedative, hypnotic, or anxiolytic dependence

Evidence of current intoxication from the substance

Clinical note explaining why the intoxication severity could not be specified

Vital signs and basic assessment during the intoxication episode

MEAT Support

HCC Buddy guidance

Documentation of sedative, hypnotic, or anxiolytic dependence

Evidence of current intoxication from the substance

Clinical note explaining why the intoxication severity could not be specified

Vital signs and basic assessment during the intoxication episode

Audit Caution

HCC Buddy guidance

Using this unspecified code when the documentation contains enough detail to determine if delirium is present or absent

Not querying the provider about the intoxication severity and complications

Confusing this code with uncomplicated intoxication — unspecified means unknown, not uncomplicated

Defaulting to this code as a shortcut rather than reviewing the full clinical picture

Common Mistakes

HCC Buddy guidance

F13.220 — Dependence with intoxication uncomplicated; use when documentation confirms no delirium

F13.221 — Dependence with intoxication delirium; use when delirium is documented

F13.929 — Unspecified sedative use with intoxication unspecified; use when dependence is not confirmed

F13.20 — Uncomplicated dependence; use when no current intoxication 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 F13.229 an HCC code?

Yes. F13.229 (Sedative, hypnotic or anxiolytic dependence with intoxication, 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: F13.229 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: F13.229
Description: Sedative, hypnotic or anxiolytic dependence with intoxication, 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 F13.229 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for F13.229

For F13.229, 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

F13.229 is the ICD-10-CM diagnosis code for sedative, hypnotic or anxiolytic dependence with intoxication, unspecified. A person dependent on sedative, hypnotic, or anti-anxiety medications is experiencing intoxication, but the specific details or severity of the intoxication are not documented. F13.229 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, F13.229 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. No V24 mapping is shown for F13.229; 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.

Use this code only when intoxication is present but cannot be classified as uncomplicated or with delirium. For F13.229, 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 F13.229 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Use this code only when intoxication is present but cannot be classified as uncomplicated or with delirium
•Request clarification from the provider about the nature and severity of intoxication symptoms

Clinical Significance

This code indicates sedative dependence with intoxication where the severity or complications of the intoxication are not specified. It represents a documentation gap where the provider has identified both dependence and intoxication but has not clarified whether delirium or other complications are present. This is an opportunity for clinical documentation improvement.

Documentation Requirements

✓Documentation of sedative, hypnotic, or anxiolytic dependence
✓Evidence of current intoxication from the substance
✓Clinical note explaining why the intoxication severity could not be specified
✓Vital signs and basic assessment during the intoxication episode
✓Substance type and any available details about the intoxication presentation

Commonly Confused Codes

•F13.220: Dependence with intoxication uncomplicated; use when documentation confirms no delirium
•F13.221: Dependence with intoxication delirium; use when delirium is documented
•F13.929: Unspecified sedative use with intoxication unspecified; use when dependence is not confirmed
•F13.20: Uncomplicated dependence; use when no current intoxication is present
•F13.129: Sedative ABUSE with intoxication unspecified; requires abuse rather than dependence