What is ICD-10 code F13.232?

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 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. F13.232 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. F13.232 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. F13.232 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.

What is the V28 vs V24 difference for F13.232?

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. For F13.232, V28 maps to Drug/Alcohol Psychosis at RAF 0.000 while V24 mapped to Drug/Alcohol Psychosis at RAF 0.434. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting F13.232?

Document the specific perceptual disturbances (visual, auditory, tactile hallucinations) Distinguish from F13.231 which includes delirium as a more severe complication Because F13.232 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score.

F13.232 ICD-10 Code: Sedative, hypnotic

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupF13.232Effective 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)

F13.232

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

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.

Buddy Insight

CMS-HCC V28

Mapped

HCC 135

Drug/Alcohol Psychosis

RAF 0.0

CMS-HCC V24

Mapped

HCC 54

Drug/Alcohol Psychosis

RAF 0.434

ACA/HHS

Not risk-adjusted for this model/period.

RAF 0

ESRD/PACE

Mapped

HCC 54

Drug/Alcohol Psychosis

RAF 0.0

RXHCC

Not risk-adjusted for this model/period.

RAF 0

Code Trumping

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Code Book Path

Official

F13.2Sedative, hypnotic or anxiolytic-related dependence

F13.23Sedative, hypnotic or anxiolytic dependence with withdrawal

F13.232Sedative, hypnotic or anxiolytic dependence with withdrawal with perceptual disturbance

Inclusion Terms

Official

Sedative, hypnotic, or anxiolytic withdrawal with perceptual disturbances

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for F13.232 in this effective period.

Related Child Codes

Official

F13.230Sedative, hypnotic or anxiolytic dependence with withdrawal, uncomplicated

F13.231Sedative, hypnotic or anxiolytic dependence with withdrawal delirium

F13.239Sedative, hypnotic or anxiolytic dependence with withdrawal, unspecified

Includes

Official

ICD-10-CM does not list Includes notes for F13.232 in this effective period.

Excludes 1

Official

sedative, hypnotic or anxiolytic dependence with intoxication (F13.22-)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for F13.232 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for F13.232 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for F13.232 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

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

MEAT Support

HCC Buddy guidance

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

Audit Caution

HCC Buddy guidance

Coding this as withdrawal delirium (F13.231) when the patient has perceptual disturbances but maintains orientation

Coding uncomplicated withdrawal when the patient reports seeing or hearing things during withdrawal

Confusing substance-induced psychotic hallucinations (during use) with withdrawal-related perceptual disturbances

Not recognizing that perceptual disturbances are a warning sign of potential delirium progression

Common Mistakes

HCC Buddy guidance

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

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Is F13.232 an HCC code?

Yes. F13.232 maps to Drug/Alcohol Psychosis under the CMS-HCC V28 risk adjustment model (and Drug/Alcohol Psychosis under V24).

HCC Category Mapping

V28HCC 135, Drug/Alcohol Psychosis

0.000

V24HCC 54, Drug/Alcohol Psychosis

0.434

ESRDHCC 54, Drug/Alcohol Psychosis

0.000

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 F13.232

For F13.232to 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 F13.232 during that encounter, not just copy-forwarded from a problem list.

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/Alcohol Psychosis (HCC 135) with a community, non-dual, aged base RAF weight of 0.000. Under the older V24 model, F13.232 mapped to the same category but with a base RAF weight of 0.434, V28 recalibrated weights across the entire model. 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 perceptual disturbances (visual, auditory, tactile hallucinations). Because F13.232 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 F13.232 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