F13.939
BillableSedative, hypnotic or anxiolytic use, unspecified with withdrawal, unspecified
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is F13.939 an HCC code?
Yes. F13.939 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 F13.939
For F13.939 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 F13.939 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F13.939 is the ICD-10-CM diagnosis code for sedative, hypnotic or anxiolytic use, unspecified with withdrawal, unspecified. A person is experiencing withdrawal symptoms from sedative, hypnotic, or anti-anxiety medications, but the specific withdrawal symptoms are not detailed. F13.939 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, F13.939 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, F13.939 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.
This is a non-specific withdrawal code; query provider for specific symptoms (tremor, anxiety, seizures, etc.) to assign more precise codes if available. Because F13.939 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 F13.939 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This is a non-specific withdrawal code; query provider for specific symptoms (tremor, anxiety, seizures, etc.) to assign more precise codes if available
- •Document vital signs and physical examination findings related to withdrawal syndrome
Clinical Significance
This doubly unspecified code indicates sedative withdrawal where both the use pattern and withdrawal severity are undocumented. While this captures the withdrawal episode, the lack of specificity limits clinical utility. Given the potentially life-threatening nature of sedative withdrawal, clarifying whether delirium or perceptual disturbances are present is important for both patient safety and accurate risk adjustment.
Documentation Requirements
- ✓Documentation of withdrawal from sedative, hypnotic, or anxiolytic substance
- ✓Any available clinical details about withdrawal severity and symptoms
- ✓Vital signs during the withdrawal period
- ✓Notation explaining why more specific classification could not be made
- ✓Basic assessment of mental status and orientation