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F13.950 ICD-10-CM Code: Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced psychotic disorder with delusions

F13.950 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 · free HCC coding tools

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Code lookupF13.950

FY 2026 Apr update / Mental, Behavioral and Neurodevelopmental disorders (F01-F99) / Mental and behavioral disorders due to psychoactive substance use (F10-F19)

F13.950

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

Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced psychotic disorder with delusions

A person is experiencing delusions (false beliefs) caused by sedative, hypnotic, or anti-anxiety medication use.

Buddy the Bee presenting code insight

Buddy Insight

Unspecified sedative use with induced psychotic disorder featuring delusions represents a serious psychiatric complication where the patient has developed fixed false beliefs from sedative use.

OverviewRisk ModelsCode BookDocumentationAuditNotesEdition comparison

CMS-HCC V28

HCC 135

Coefficient HCC 135: 0.424 (Community Non-Dual Aged (CNA))

CMS-HCC V24

Historical

Historical

Not used for CY2026 payment

ACA/HHS

HCC 081

Code-level coefficient reference

ESRD/PACE

HCC 54

Code-level coefficient reference

RXHCC

N/A

—

Not mapped

Code Book Path

Official
F13.9Sedative, hypnotic or anxiolytic-related use, unspecifiedF13.95Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced psychotic disorderF13.950Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced psychotic disorder with delusions

Inclusion Terms

Official

No inclusion terms are included in this display for F13.950. 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

Related Codes

Official
F13.951Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced psychotic disorder with hallucinationsF13.959Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced psychotic disorder, unspecified

Includes

Official
  • disorders of psychological developmentInherited from F01-F99

Excludes 1

Official
  • sedative, hypnotic or anxiolytic-related abuse (F13.1-)Inherited from F13.9
  • sedative, hypnotic or anxiolytic-related dependence (F13.2-)Inherited from F13.9

Code First

Official

No Code First sequencing instructions are included in this display for F13.950. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for F13.950. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for F13.950. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance
Documentation of sedative, hypnotic, or anxiolytic use
Detailed description of delusions (content, type, persistence)
Clinical evidence that delusions are substance-induced, not primary psychotic disorder
Mental status examination with psychotic symptom documentation

MEAT Support

HCC Buddy guidance
Documentation of sedative, hypnotic, or anxiolytic use
Detailed description of delusions (content, type, persistence)
Clinical evidence that delusions are substance-induced, not primary psychotic disorder
Mental status examination with psychotic symptom documentation

Audit Caution

HCC Buddy guidance
Coding primary delusional disorder instead of substance-induced psychosis
Using the unspecified psychotic disorder code when delusions are clearly documented
Not establishing the temporal link between substance use and delusional onset
Missing the higher HCC opportunity by coding only the substance use pattern

Common Mistakes

HCC Buddy guidance
F13.951 — Unspecified use with induced hallucinations; different psychotic symptom type
F13.959 — Unspecified use with unspecified psychotic disorder; use when symptom type is unknown
F13.150 — Sedative ABUSE with psychotic disorder with delusions; when abuse is confirmed
F13.250 — Sedative DEPENDENCE with psychotic disorder with delusions; when dependence is confirmed

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 F13.950 an HCC code?

Yes. F13.950 (Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced psychotic disorder with delusions) 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: F13.950 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
F13.950
Description
Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced psychotic disorder with delusions
HCC (V28)
HCC 135 — Drug Use with Psychotic Complications
RAF reference coefficient
0.424
Billable
Yes
Payment year
2026

HCC Category Mapping

V28HCC 135, Drug Use with Psychotic Complications
0.424
ESRDHCC 54, Substance Use with Psychotic 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 F13.950 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for F13.950

For F13.950, 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

F13.950 is the ICD-10-CM diagnosis code for sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced psychotic disorder with delusions. A person is experiencing delusions (false beliefs) caused by sedative, hypnotic, or anti-anxiety medication use. F13.950 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, F13.950 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 F13.950; 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 content and nature of delusions and confirm they are substance-induced rather than primary psychotic disorder. For F13.950, 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 F13.950 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • •Document the content and nature of delusions and confirm they are substance-induced rather than primary psychotic disorder
  • •Note the timeline of substance use relative to onset of delusions

Clinical Significance

Unspecified sedative use with induced psychotic disorder featuring delusions represents a serious psychiatric complication where the patient has developed fixed false beliefs from sedative use. The unspecified use pattern is secondary to the severity of the psychotic presentation. This maps to the highest substance use HCC category and requires urgent psychiatric assessment.

Documentation Requirements

  • ✓Documentation of sedative, hypnotic, or anxiolytic use
  • ✓Detailed description of delusions (content, type, persistence)
  • ✓Clinical evidence that delusions are substance-induced, not primary psychotic disorder
  • ✓Mental status examination with psychotic symptom documentation
  • ✓Timeline of substance use and delusional onset
  • ✓Safety assessment and treatment plan

Commonly Confused Codes

  • •F13.951: Unspecified use with induced hallucinations; different psychotic symptom type
  • •F13.959: Unspecified use with unspecified psychotic disorder; use when symptom type is unknown
  • •F13.150: Sedative ABUSE with psychotic disorder with delusions; when abuse is confirmed
  • •F13.250: Sedative DEPENDENCE with psychotic disorder with delusions; when dependence is confirmed
  • •F22: Delusional disorders; primary psychotic disorder, not substance-induced

Child Codes

F13.950Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced psychotic disorder with delusions
HCC 135
F13.951Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced psychotic disorder with hallucinations
HCC 135
F13.959Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced psychotic disorder, unspecified
HCC 135

Code Hierarchy

└F13Sedative, hypnotic, or anxiolytic related disorders└F13.9Sedative, hypnotic or anxiolytic-related use, unspecified└F13.95Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced psychotic disorder└F13.950Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced psychotic disorder with delusions
└F13.950Sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced psychotic disorder with delusions

Also searched as

  • F13 950
  • F13950

For F13.950, 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.

F13.950 maps to CMS-HCC V28 category 135, Drug Use with Psychotic Complications. See the ICD-10 to HCC mapping hub for how the V28 crosswalk works. The mapping identifies a payment HCC category for F13.950. Review its source-labeled HCC coefficient above, check the RAF Calculator with complete member context for CMS-HCC V28 PY2026, and confirm the documentation the chart needs before the code is submitted. HCC Buddy shows no RAF score unless every required source and calculation check passes.

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