F13.232 ICD-10-CM Code: Sedative, hypnotic or anxiolytic dependence with withdrawal with perceptual disturbance
F13.232 maps to CMS-HCC V28 135. 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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FY 2026 Apr update / Mental, Behavioral and Neurodevelopmental disorders (F01-F99) / Mental and behavioral disorders due to psychoactive substance use (F10-F19)
F13.232
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceSedative, hypnotic or anxiolytic dependence with withdrawal with perceptual disturbance
A person dependent on sedative, hypnotic, or anti-anxiety medications is experiencing withdrawal with perceptual disturbances such as hallucinations or illusions, but without full delirium.
Buddy Insight
Withdrawal with perceptual disturbance represents a severe complication of sedative withdrawal where the patient experiences hallucinations or illusions while maintaining orientation, unlike full delirium.
CMS-HCC V28
MappedHCC 135
Code-level coefficient reference
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
MappedHCC 081
Code-level coefficient reference
ESRD/PACE
MappedHCC 54
Code-level coefficient reference
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
Official- Sedative, hypnotic, or anxiolytic withdrawal with perceptual disturbances
- Sedative, hypnotic, or anxiolytic use disorder, moderateInherited from F13.23
- Sedative, hypnotic, or anxiolytic use disorder, severeInherited from F13.23
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
Includes
Official- disorders of psychological developmentInherited from F01-F99
Excludes 1
Official- sedative, hypnotic or anxiolytic-related abuse (F13.1-)Inherited from F13.2, F13.23
- sedative, hypnotic, or anxiolytic use, unspecified (F13.9-)Inherited from F13.2, F13.23
- sedative, hypnotic or anxiolytic dependence with intoxication (F13.22-)Inherited from F13.2, F13.23
Code First
OfficialNo Code First sequencing instructions are included in this display for F13.232. Check the code and parent instructions in the Code Book.
Use Additional
OfficialNo Use Additional Code instructions are included in this display for F13.232. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for F13.232. 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 F13.232 an HCC code?
Yes. F13.232 (Sedative, hypnotic or anxiolytic dependence with withdrawal with perceptual disturbance) maps to HCC 135, Drug Use with 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: F13.232 is billable and maps to V28 HCC 135, Drug Use with Psychotic Complications. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.
- Code
- F13.232
- Description
- Sedative, hypnotic or anxiolytic dependence with withdrawal with perceptual disturbance
- HCC (V28)
- HCC 135 — Drug Use with Psychotic Complications
- RAF reference coefficient
- 0.424
- 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 F13.232 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT review for F13.232
For F13.232, 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
F13.232 is the ICD-10-CM diagnosis code for sedative, hypnotic or anxiolytic dependence with withdrawal with perceptual disturbance. A person dependent on sedative, hypnotic, or anti-anxiety medications is experiencing withdrawal with perceptual disturbances such as hallucinations or illusions, but without full delirium. F13.232 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, F13.232 maps to Drug Use with Psychotic Complications (HCC 135) with a source-labeled community, non-dual, aged reference coefficient of 0.424. No V24 mapping is shown for F13.232; 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.
Document the specific perceptual disturbances (visual, auditory, tactile hallucinations). For F13.232, 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 F13.232 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document the specific perceptual disturbances (visual, auditory, tactile hallucinations)
- •Distinguish from F13.231 which includes delirium as a more severe complication
Clinical Significance
Withdrawal with perceptual disturbance represents a severe complication of sedative withdrawal where the patient experiences hallucinations or illusions while maintaining orientation, unlike full delirium. This is a warning sign of potential progression to delirium and requires close monitoring. The perceptual disturbances typically include visual or tactile hallucinations and indicate significant central nervous system irritability during withdrawal.
Documentation Requirements
- ✓Documentation of sedative, hypnotic, or anxiolytic dependence
- ✓Description of specific perceptual disturbances (visual, auditory, tactile hallucinations or illusions)
- ✓Clinical confirmation that full delirium criteria are NOT met (patient maintains basic orientation)
- ✓Timeline of substance cessation and onset of perceptual symptoms
- ✓Withdrawal severity scoring (CIWA-B or equivalent)
- ✓Monitoring plan and interventions for potential progression to delirium
Commonly Confused Codes
- •F13.231: Withdrawal delirium; full delirium with disorientation, more severe than perceptual disturbance alone
- •F13.230: Withdrawal uncomplicated; no perceptual disturbances present
- •F13.251: Dependence with induced psychotic disorder with hallucinations; occurs during active use, not withdrawal
- •F13.239: Withdrawal unspecified; use when presence of complications cannot be determined
- •F13.932: Unspecified use with withdrawal with perceptual disturbance; use when dependence is not confirmed