F13.980
BillableSedative, hypnotic or anxiolytic use, unspecified 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 F13.980 an HCC code?
Yes. F13.980 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 F13.980
For F13.980 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 F13.980 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
F13.980 is the ICD-10-CM diagnosis code for sedative, hypnotic or anxiolytic use, unspecified with sedative, hypnotic or anxiolytic-induced anxiety disorder. A person uses sedative, hypnotic, or anti-anxiety medications without a diagnosed substance use disorder and develops anxiety as a result of using these drugs. F13.980 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, F13.980 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, F13.980 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 code indicates unspecified use pattern (not abuse or dependence) with a specific induced condition; verify documentation doesn't indicate abuse or dependence which would require different codes. Because F13.980 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 F13.980 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This code indicates unspecified use pattern (not abuse or dependence) with a specific induced condition; verify documentation doesn't indicate abuse or dependence which would require different codes
- •Ensure the anxiety disorder is documented as directly induced by the sedative/hypnotic/anxiolytic use rather than a pre-existing condition
Clinical Significance
Unspecified sedative use with induced anxiety disorder indicates anxiety symptoms caused by sedative use where the use pattern has not been classified. This paradoxical complication is well-recognized with benzodiazepine use. The unspecified use status reflects incomplete documentation of the substance use pattern, which should be clarified when possible.
Documentation Requirements
- ✓Documentation of sedative, hypnotic, or anxiolytic use
- ✓Description of anxiety symptoms attributed to the substance
- ✓Temporal relationship between substance use and anxiety onset
- ✓Clinical distinction from pre-existing primary anxiety disorders
- ✓Differentiation from withdrawal anxiety
- ✓Assessment of anxiety severity