F13.280
BillableSedative, hypnotic or anxiolytic dependence with sedative, hypnotic or anxiolytic-induced anxiety disorder
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F13.280 an HCC code?
Yes. F13.280 maps to Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications under the CMS-HCC V28 risk adjustment model (and Substance Use Disorder, Moderate/Severe, or Substance Use with Complications 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 F13.280
For F13.280to 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 F13.280 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F13.280 is the ICD-10-CM diagnosis code for sedative, hypnotic or anxiolytic dependence with sedative, hypnotic or anxiolytic-induced anxiety disorder. A person is dependent on sedatives, sleeping pills, or anti-anxiety medications and is experiencing anxiety symptoms caused by these drugs. F13.280 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, F13.280 maps to Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications (HCC 137) with a community, non-dual, aged base RAF weight of 0.424. Under the older CMS-HCC V24 model, F13.280 maps to Substance Use Disorder, Moderate/Severe, or Substance Use with Complications (HCC 55) with a community, non-dual, aged base RAF weight of 0.329. 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.
This paradoxical effect (anxiety from anti-anxiety medications) should be clearly documented by the provider. Because F13.280 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 F13.280 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This paradoxical effect (anxiety from anti-anxiety medications) should be clearly documented by the provider
- •Differentiate between anxiety as a withdrawal symptom versus anxiety induced during active use
Clinical Significance
Sedative dependence with induced anxiety disorder is a paradoxical but well-recognized complication where chronic anxiolytic dependence actually causes or worsens anxiety. This is common with benzodiazepine dependence, where neuroadaptation leads to increased baseline anxiety. The dual nature of this condition — depending on a substance that worsens the target symptom — creates treatment challenges and reflects significant clinical complexity.
Documentation Requirements
- ✓Documentation of sedative, hypnotic, or anxiolytic dependence
- ✓Description of anxiety symptoms and their relationship to the substance use
- ✓Clinical distinction from pre-existing primary anxiety disorder
- ✓Differentiation from withdrawal-related anxiety versus substance-induced anxiety disorder
- ✓Assessment of anxiety severity (GAD-7 or similar scale if available)
- ✓Treatment plan addressing both the dependence and the induced anxiety
Commonly Confused Codes
- •F13.180 — Sedative ABUSE with induced anxiety disorder; less severe use pattern
- •F13.980 — Unspecified sedative use with induced anxiety; use when dependence is not confirmed
- •F41.1 — Generalized anxiety disorder; primary anxiety, not substance-induced
- •F13.230 — Dependence with withdrawal uncomplicated; withdrawal anxiety is a different clinical entity
- •F13.24 — Dependence with induced mood disorder; different type of induced psychiatric complication